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Improved Maternal and Infant Outcomes with Serial, Self-Reported Early Prenatal Substance Use Screening.

Stacy L Boden1, Cresta W Jones2, Erwin T Cabacungan3

  • 1Department of Pediatrics, West Bend Health Center, Froedtert Health & the Medical College of Wisconsin, 1700 W Paradise Drive, West Bend, WI, 53095, USA. stacy.boden@froedtert.com.

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Serial early prenatal substance use screening significantly reduces maternal substance use and improves infant outcomes. Early identification is key for timely intervention and better maternal and neonatal health.

Keywords:
Infant outcomesMaternal outcomesPrenatal screeningSubstance use

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Public Health

Background:

  • Current prenatal substance use screening tools lack validation and are often used inconsistently, failing to capture ongoing substance use during pregnancy.
  • The study addresses the need for validated, serial screening methods to accurately assess and manage substance use throughout gestation.

Purpose of the Study:

  • To investigate the impact of serial early prenatal substance use screening on maternal substance use patterns and pregnancy outcomes.
  • To determine if early and repeated screening leads to reduced substance use by the end of pregnancy and improved maternal and infant health.

Main Methods:

  • A retrospective cohort study analyzed data from mothers and infants between January 2015 and December 2017.
  • A self-reported substance screening tool was administered at the initial prenatal visit and at subsequent visits until delivery.
  • Mothers were categorized into groups based on the trimester of their first screening, with adjustments for demographics and risk factors.

Main Results:

  • Mothers screened in the first trimester averaged ≥3 screens during pregnancy (52%), compared to only 6% screened in the third trimester (p < 0.001).
  • Early screening (first trimester) was associated with a seven-fold decrease in any substance use and a nine-fold decrease in marijuana use compared to third-trimester screening.
  • First-trimester screening correlated with a five-fold increase in negative maternal urine drug screens, a 3.5-fold increase in well newborn diagnoses, and a five-fold increase in avoiding infant morphine treatment.

Conclusions:

  • Serial early prenatal screening for substance use is linked to improved maternal and infant outcomes.
  • Early identification of maternal substance use facilitates prompt referral for prevention, treatment, and social services.
  • Further research into universal, serial early prenatal screening protocols is warranted to optimize maternal and child health.