title: Syphilis, gonorrhoea, and drug abuse among pregnant women in Jefferson County, Alabama, US, 1980-94: monitoring trends through systematically collected health services data.
abstract: OBJECTIVE
  To assess the association between self reported drug abuse and syphilis and gonorrhoea among pregnant women, Jefferson County, Alabama, United States, 1980-94.
  
  
  METHODS
  We analysed a prenatal care database and assessed the association of self reported drug use with seropositive syphilis and gonorrhoea using prevalence rates, multiple logistic regression models, and the Pearson correlation coefficient (r) for trends.
  
  
  RESULTS
  Overall, 5.5% of the women acknowledged drug abuse, 1.4% had seropositive syphilis, and 4.8% had gonorrhoea. In a multivariate analysis, drug abuse was associated with syphilis (odds ratio 2.9, 95% confidence interval 1.6, 5.3) but not with gonorrhoea. Trends in the annual prevalence of drug abuse closely paralleled trends in the annual prevalence of syphilis, including simultaneous peaks in 1992 (drug abuse, 9.1%; syphilis, 3.2%). There was no such parallel trend between drug abuse and gonorrhoea. Annual prevalence of drug abuse correlated with the prevalence of syphilis (r = 0.89, p = 0.001) more than with the prevalence of gonorrhoea (r = 0.45, p = 0.201).
  
  
  CONCLUSIONS
  Among pregnant women, an increase in drug abuse was closely associated with an epidemic of syphilis, but not of gonorrhoea. Systematically collected prenatal care data can usefully supplement surveillance of diseases and behavioural risk factors associated with them.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: S H
authors.initials: SH
authors.lastname: Ebrahim
authors.forename: W W
authors.initials: WW
authors.lastname: Andrews
authors.forename: A A
authors.initials: AA
authors.lastname: Zaidi
authors.forename: W C
authors.initials: WC
authors.lastname: Levine
authors.forename: M B
authors.initials: MB
authors.lastname: DuBard
authors.forename: R L
authors.initials: RL
authors.lastname: Goldenberg
mesh_terms: D000328:Adult; D000407:Alabama / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology*; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011295:Prenatal Care; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012725:Sexual Behavior; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013587:Syphilis / Q000453:epidemiology*