The impact of continuing illegal drug use on teenage pregnancy outcomes--a prospective cohort study.
OBJECTIVE
To evaluate the impact of continuing illegal drug use on teenage pregnancy outcomes.


METHODS
Prospective cohort study.


METHODS
Three Australian obstetric hospitals.


METHODS
Four hundred and fifty-six teenage antenatal patients.


METHODS
Teenage antenatal patients were interviewed and completed questionnaires to establish their pattern of non-prescription drug use before and during pregnancy. Illegal drug use data provided by the participants were validated in a subgroup of 180 who were interviewed six months postpartum. Antenatal, intrapartum and postnatal outcomes were collated independently. Data were analysed using SAS.


METHODS
Antenatal co-morbidity, delivery and newborn outcomes.


RESULTS
In the cohort, 20.3% used marijuana throughout their pregnancy. However, 33.5% of these were multidrug users. The remaining 79.6% did not use illegal drugs throughout pregnancy (non-users). However, half the 'non-users' were 'ex-users' who ceased drug use immediately before or during early pregnancy. Illegal drug use was associated with an increased incidence of concurrent cigarette and alcohol use (both OR > 4.1 and P < 0.0001) and social and psychiatric morbidity (all OR > 1.95 and P < 0.001). Multidrug use was associated with a significant increase in the incidence of chlamydial and other endocervical infections (chlamydia: OR = 4.2,95% CI = 1.6-10.9; endocervical infections: OR = 2.6,95% CI = 1.1-5.7). After controlling for significant covariates, and in the setting of good antenatal care, the only difference in outcome was a significant linear trend towards an increased incidence of threatened preterm labour across the three groups (P = 0.02). Of note, there were no effects on birthweight, birthweight ratio or preterm birth.


CONCLUSIONS
Good antenatal care may be able to ameliorate many adverse pregnancy outcomes in teenagers who use illegal drugs throughout pregnancy. The high levels of coexisting psychosocial morbidity are a concern for future mothercrafting.
Quinlivan
Julie A
JA
Department of Obstetrics and Gynaecology, The University of Melbourne, Victoria, Australia.
Evans
Sharon F
SF
D000293:Adolescent; D001315:Australia; D002648:Child; D015331:Cohort Studies; D017579:Domestic Violence; D005260:Female; D005865:Gestational Age; D018453:Homeless Youth; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence; D011295:Prenatal Care / Q000379:methods; D011446:Prospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications*