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Routine urine drug screening at the first prenatal visit
G H Colmorgen1, C Johnson, M A Zazzarino
1Department of Obstetrics and Gynecology, Medical Center of Delaware, Inc., Newark 19718.
American Journal of Obstetrics and Gynecology
|February 1, 1992
Summary
Routine prenatal urine drug screening identifies illicit substance users, enabling early intervention. Despite denials, drug use is linked to increased maternal complications and decreased neonatal birth weight and gestational age.
Area of Science:
- Obstetrics and Gynecology
- Clinical Pharmacology
- Neonatal Medicine
Background:
- Illicit substance use during pregnancy poses significant risks to both maternal and fetal health.
- Early identification of substance use is crucial for timely intervention and improved outcomes.
Purpose of the Study:
- To evaluate the effectiveness of routine urine drug screening at the first prenatal visit for identifying pregnant individuals using illicit substances.
- To assess the potential for early intervention based on screening results.
Main Methods:
- A comparative study involving 166 patients with positive and 150 with negative urine drug screens (enzyme multiplied immunoassay test).
- Statistical analyses included unpaired t tests, chi-squared tests, probit analysis, and tests of independent Poisson distributions to compare outcomes.
Main Results:
- Forty percent of individuals with positive drug screens denied illicit substance use.
- Drug-using individuals experienced increased antepartum (p<0.01) and postpartum (p<0.05) complications.
- Neonates born to drug-using mothers showed decreased birth weight (p<0.001), gestational age (p<0.03), and head circumference (p<0.05).
Conclusions:
- Routine urine drug screening at the first prenatal visit is a valuable tool for identifying illicit substance use.
- Given the challenges in self-reporting, universal screening should be considered in populations with high rates of substance use.
- Early detection facilitates necessary interventions to mitigate adverse maternal and neonatal outcomes.