Abstract
Background. There is a paucity of research in Australia on the characteristics of women in treatment for illicit substance use in pregnancy and the health outcomes of their neonates. Aims. To determine the clinical features and outcomes of high-risk, marginalized women seeking treatment for illicit substance use in pregnancy and their neonates. Methods. 139 women with a history of substance abuse/dependence engaged with a perinatal drug health service in Sydney, Australia. Maternal (demographic, drug use, psychological, physical, obstetric, and antenatal care) and neonatal characteristics (delivery, early health outcomes) were examined. Results. Compared to national figures, pregnant women attending a specialist perinatal and family drug health service were more likely to report being Australian born, Aboriginal or Torres Strait Islander, younger, unemployed, and multiparous. Opiates were the primary drug of concern (81.3%). Pregnancy complications were common (61.9%). Neonates were more likely to be preterm, have low birth weight, and be admitted to special care nursery. NAS was the most prevalent birth complication (69.8%) and almost half required pharmacotherapy. Conclusion. Mother-infant dyads affected by substance use in pregnancy are at significant risk. There is a need to review clinical models of care and examine the longer-term impacts on infant development.
Highlights
Illicit drug use is a major problem in young adults and increasingly in young women [1]
Perinatal substance use has been found to be associated with a higher incidence of pregnancy complications, including miscarriage, stillbirth, fetal growth retardation, decreased birth weight and head circumference, premature delivery, meconium staining, cerebral infarctions, maternal health problems, and maternal/neonatal infections and neonatal mortality [5,6,7,8,9,10]
The results were compared with figures published in Australia’s mothers and babies (AMAB) 2007 [38]
Summary
Illicit drug use is a major problem in young adults and increasingly in young women [1]. It is well documented that the myriad of health problems associated with illicit drug use is of serious concern, especially during the antenatal and postnatal period. Neonates born to mothers affected by substance use problems are more likely to be admitted to special care nurseries, have longer stays in hospital, and are at increased risk of neonatal abstinence syndrome (NAS) compared to nonexposed neonates [11,12,13,14]. There is a paucity of research in Australia on the characteristics of women in treatment for illicit substance use in pregnancy and the health outcomes of their neonates. To determine the clinical features and outcomes of high-risk, marginalized women seeking treatment for illicit substance use in pregnancy and their neonates. Maternal (demographic, drug use, psychological, physical, obstetric, and antenatal care) and neonatal characteristics (delivery, early health outcomes) were examined. There is a need to review clinical models of care and examine the longer-term impacts on infant development
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