High pregnancy rates and reproductive health indicators among female injection-drug users in Vancouver, Canada.
OBJECTIVE
To determine the incidence of pregnancy among active injection-drug users and to identify factors associated with becoming pregnant.


METHODS
The Vancouver Injection Drug User Study (VIDUS) is a prospective cohort study that began in 1996. Women who had completed a baseline and at least one follow-up questionnaire between June 1996 and January 2002 were included in the study. Parametric and non-parametric methods were used to compare characteristics of women who reported pregnancy over the study period with those who did not over the same time period.


RESULTS
A total of 104 women reported a primary pregnancy over the study period. The incidence of pregnancy over the follow-up period was 6.46 (95% confidence interval (CI) 5.24-7.87) per 100 person-years. The average age of women who reported pregnancy was younger than that of women who did not report pregnancy (27 vs. 32 years, p < 0.001). Women of Aboriginal ethnicity were more likely to report pregnancy (odds ratio 1.6, 95% CI 1.0-2.5). Comparison of drug use showed no significant differences in pregnancy rate with respect to the use of heroin, cocaine or crack (p > 0.05). In examining sexual behavior, women who reported having had a regular partner in the previous 6 months were three times more likely to have reported pregnancy. Despite the fact that 67% of women in this study reported using some form of contraception, the use of reliable birth control was low. Only 5% of women in our study reported the use of hormonal contraceptives.


CONCLUSIONS
There were a high number of pregnancies among high-risk women in this cohort. This corresponded with very low uptake of reliable contraception. Innovative strategies to provide reproductive health services to at-risk women who are injecting drugs is a public health priority.
Vancouver Injection Drug User Study (VIDUS), BC Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, Canada.
A E
AE
Weber
M W
MW
Tyndall
P M
PM
Spittal
K
K
Li
S
S
Coulter
M V
MV
O'Shaughnessy
M T
MT
Schechter
D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D016012:Poisson Distribution; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012307:Risk Factors; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous; D011795:Surveys and Questionnaires