Suivi obstétrical et pronostic périnatal chez les femmes enceintes toxicomanes

Abstract

ObjectiveTo identify the factors associated with a good obstetric follow-up and a good perinatal prognosis, in order to adapt the management of pregnant women with addiction to opiates. MethodsA retrospective study was carried out in our maternity between January 2012 and December 2014, including 104 women who were addicted to opiates, whether or not they were substituted, with or without associated consumptions, regardless of the term of delivery beyond 22 weeks of amenorrhea. ResultsA good obstetrical follow-up was observed by 32.7% of women. The father's presence (OR=3.9; P=0.0113) and investment in pregnancy (OR=4.4; P=0.0029), as well as the desired character of the pregnancy (OR=4.5; P=0.0008) appeared to be associated with the quality of the observed follow-up. Preterm deliveries (11.8 versus 35.8%; P=0.0103), and social measures taken at the discharge of the newborn from the maternity (2.9 versus 24.3%, P=0.0057) were less frequent. A good perinatal prognosis was found for 29.8% of the cases. Associated consumptions <3 (OR=2.6 [1.1–6.2]; P=0.0281) confirmed by negative urine drug screening (OR=2.9 [1.1–7.8]; P=0.0307) were more numerous. ConclusionAlthough the follow-up and the perinatal prognosis of these pregnancies have improved considerably in recent years, it seems necessary to further optimize their management.