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Perinatal Illicit Drug and Marijuana Use
Judy C Chang1, Cynthia L Holland2, Jill A Tarr2
11 Department of Obstetrics, Gynecology and Reproductive Sciences and General Internal Medicine, Magee-Womens Research Institute, and the Center for Research in Health Care, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
American Journal of Health Promotion : AJHP
|November 13, 2015
Summary
Many pregnant patients use marijuana, with a significant number not disclosing this illicit drug use to their obstetric providers during prenatal visits. This highlights a gap in communication and screening for substance use during pregnancy.
Area of Science:
- Obstetrics and Gynecology
- Addiction Medicine
- Public Health
Background:
- Perinatal substance use, including marijuana, poses risks to both maternal and fetal health.
- Effective screening and open disclosure are crucial for addressing substance use during pregnancy.
- Understanding patient disclosure patterns is vital for improving prenatal care.
Purpose of the Study:
- To evaluate the prevalence of marijuana and other illicit drug use among pregnant patients.
- To assess the effectiveness of provider screening for substance use during initial obstetric visits.
- To examine the extent of patient disclosure of substance use to healthcare providers.
Main Methods:
- An observational study was conducted in five urban prenatal clinics in Pittsburgh, Pennsylvania.
- Audio recordings of patient-provider conversations and patient urine samples were collected during first obstetric visits.
- Qualitative analysis of conversations and quantitative drug analyses of urine samples were performed to assess screening and disclosure.
Main Results:
- Of 422 participants, 81% of providers inquired about illicit drug use.
- 29% of patients disclosed any illicit drug use, with 11% reporting current marijuana use during pregnancy.
- Marijuana was the most frequently detected substance (27%) in urine samples, yet only 36% of those testing positive disclosed current use.
Conclusions:
- A substantial proportion of pregnant patients in Pennsylvania use marijuana, despite its illegal status.
- There is a significant underreporting of marijuana use by pregnant patients to their obstetric care providers.
- Improved screening strategies and patient-provider communication are needed to address perinatal substance use effectively.
Keywords:
CommunicationHealth focus: illicit drug useMarijuanaOutcome measure: behavioralPhysician CounselingPregnant WomenPrenatal CarePrevention Research. Manuscript format: researchResearch purpose: descriptiveSetting: outpatient obstetrics clinics and officesStrategy: patient-provider screening communicationStudy design: qualitativeTarget population age: adult reproductive-age women (18 to 44 years)Target population circumstances: pregnant women and obstetric care providers