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Profile of infants born to drug-using mothers: a state-wide audit
Mohamed E Abdel-Latif1, Julee Oei, Fiona Craig
1Department of Neonatology, The Canberra Hospital, Garran, Australian Capital Territory, Australia.
Insights
Infants born to mothers using illicit drugs faced significant risks, including prematurity and low birthweight. Coordinated care is essential for these vulnerable mother-infant pairs.
Area of Science:
- Perinatal health
- Neonatal outcomes
- Public health
Background:
- Illicit drug use during pregnancy poses risks to both mother and infant.
- Understanding the characteristics and outcomes of infants exposed to drugs in utero is crucial for targeted interventions.
Purpose of the Study:
- To investigate the prevalence and characteristics of infants born to mothers using illicit drugs.
- To determine the short-term health and hospital outcomes for these infants.
Main Methods:
- Retrospective review of hospital records and Drug and Alcohol Services data.
- Inclusion of all public hospitals with obstetric services in New South Wales and Australian Capital Territory in 2004.
Main Results:
- 1.4% of confinements involved mothers using illicit drugs; opiates, amphetamines, and polydrug use were most common.
- High rates of prematurity (23.6%), low birthweight (27.1%), and nursery admissions (51.1%) were observed.
- Significant need for pharmacological withdrawal treatment (23.2%), with many infants discharged on medication (70.8%); 40.6% required child-at-risk notifications.
Conclusions:
- Illicit drug use in pregnancy is prevalent, leading to adverse perinatal and hospital outcomes.
- These infants and mothers require coordinated healthcare and resources addressing social, medical, and mental health needs.
Aims:
To ascertain the characteristics and short-term outcomes of infants born to illicit drug-using mothers in public hospitals in the state of New South Wales and the Australian Capital Territory during 2004.
Methods:
Patients were identified retrospectively by hospital records searches using ICD-10 morbidity codes and records of local Drug and Alcohol Services. Records were reviewed on site. All public hospitals (n= 101) with obstetric services were included.
Results:
A total of 879 (1.4%, 95% confidence interval: 1.3-1.5%) drug-using mothers were identified from 62,682 confinements. Opiates (46.8%), amphetamines (23.0%) and polydrug (16.4%) exposure were most common. There were eight stillbirths. Among these 871 infants, prematurity (23.6%) and low birthweight (27.1%) were common and 51.1% were admitted to nurseries for further care. Two infants died. Major congenital anomalies were detected in 15 infants. Pharmacological treatment for withdrawal was required for 202 (23.2%), and 143 (70.8%) infants were discharged home on medication. Infants who completed inpatient pharmacological treatment were hospitalised longer (median 26.0 vs. 12.0 days) and were more likely to be premature (37.3 vs. 14.0%). Child-at-risk notifications affected 40.6% of the infants, and 7.6% were fostered prior to discharge. A total of 333 (38.2%) infants were breastfed at discharge.
Conclusions:
Our regional study highlights a substantial prevalence of drug use in pregnancy with considerable adverse perinatal and hospital outcomes in infants born to these mothers. Coordinated health care and resources are needed to support these mother-infant pairs because of their social, medical and mental-health issues.
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