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Incidence of narcotic abuse during pregnancy in northwestern Ontario: three-year prospective cohort study
Len Kelly1, John Guilfoyle2, Joe Dooley2
1Professor in the Division of Clinical Sciences at the Northern Ontario School of Medicine and a rural physician and clinical researcher in Sioux Lookout, Ont. lkelly@mcmaster.ca.
Objective:
To document the incidence and outcomes of narcotic use during pregnancy in northwestern Ontario.
Design:
Three-year prospective cohort study.
Setting:
Sioux Lookout and surrounding communities in northwestern Ontario.
Participants:
A total of 1206 consecutive births in a catchment area of 28 000 First Nations patients.
Main Outcome Measures:
Incidence of narcotic use, and maternal and neonatal outcomes.
Results:
Incidence of narcotic use in pregnancy has risen to 28.6% (P < .001) and incidence of neonatal abstinence syndrome has fallen to 18.0% of narcotic-exposed births (P = .003). Daily intravenous drug use is now a common pattern of abuse.
Conclusion:
Narcotic abuse in pregnancy has dramatically increased in northwestern Ontario. Neonatal outcomes have improved as a result of a family medicine-based prenatal and obstetric program that includes a narcotic replacement and tapering program.
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