The drug epidemic: effects on newborn infants and health resource consumption at a tertiary perinatal centre.
OBJECTIVE
Illicit drug taking in Australia, with its attendant social and medical consequences, is increasing and the effects extend to maternity hospitals where infants born to addicted mothers have more health problems in the neonatal period. The aims of this study were to evaluate (1) the patterns of illness of such infants and (2) the burden imposed on the neonatal department of a large tertiary maternity centre.


METHODS
An audit was conducted of all Chemical Dependency Unit (CDU) mothers and babies delivered at the Royal Women's Hospital, Melbourne, Australia during 1997. Data were compared with those from a concurrent control group of mothers and babies randomly generated from the hospital's obstetric database.


RESULTS
Ninety-six infants born to CDU mothers were compared with a control group of 200 infant/mother pairs. The majority of women in the CDU clinic were treated for narcotic addiction with methadone (90%) but most continued to use heroin during pregnancy (68%). Infants born to CDU mothers were significantly less mature and lighter than control infants. Fifty-three (55%) CDU infants required admission to the Special Care Nursery either because of neonatal abstinence syndrome (n = 29) or other medical reasons (n = 24). The median length of hospital stay was significantly longer in CDU compared with control infants (8 vs 3 days, P < 0.01).


CONCLUSIONS
Infants born to drug dependent mothers have more neonatal problems requiring specialized medical and nursing expertise, compared with control infants. These infants are large consumers of scarce health resources.
Kelly
J J
JJ
The Division of Newborn Services, the Royal Women's Hospital, Melbourne, Australia.
Davis
P G
PG
Henschke
P N
PN
D000328:Adult; D000554:Ambulatory Care Facilities; D000662:Amphetamines; D001315:Australia; D001569:Benzodiazepines; D002188:Cannabis; D003042:Cocaine; D015897:Comorbidity; D005260:Female; D006295:Health Resources / Q000191:economics*; D003932:Heroin; D006786:Hospitals, Urban; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000139:chemically induced / Q000453:epidemiology* / Q000628:therapy; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008238:Lysergic Acid Diethylamide; D008297:Male; D008431:Maternal-Fetal Exchange; D008485:Medical Audit; D008691:Methadone; D011247:Pregnancy; D011248:Pregnancy Complications / Q000191:economics / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects; D019966:Substance-Related Disorders / Q000191:economics* / Q000453:epidemiology*
D000662:Amphetamines; D001569:Benzodiazepines; D003932:Heroin; D008238:Lysergic Acid Diethylamide; D003042:Cocaine; D008691:Methadone