title: Severity of drug use, initiation of prenatal care, and maternal-fetal attachment in pregnant marijuana and cocaine/heroin users.
abstract: OBJECTIVE
  To compare the severity of drug use, initiation of prenatal care, and maternal-fetal attachment between pregnant marijuana and cocaine/heroin users.
  
  
  METHODS
  A cross-sectional design.
  
  
  METHODS
  A prenatal clinic of a medical center in the northeast of the United States.
  
  
  METHODS
  19 marijuana, 17 cocaine, and 4 heroin users. Cocaine and heroin users were combined in one group.
  
  
  METHODS
  The Severity of Drug Use Questionnaire containing 11 questions of withdrawal, dependence, and medical, legal, and interpersonal issues was used to assess the severity of drug use. Initiation of prenatal care was obtained from the chart and was calculated by weeks of gestation when care began. Cranley's Maternal-Fetal Attachment Scale measured maternal-fetal attachment.
  
  
  RESULTS
  Pregnant cocaine/heroin users were 6 years older, had experienced more pregnancies, had higher drug severity scores, and initiated prenatal care later than marijuana users. No significant difference in maternal-fetal attachment was found.
  
  
  CONCLUSIONS
  Interventions to help especially cocaine/heroin users initiate early prenatal care and reduce severity of drug use are indicated.
authors.affiliation: Department of Environments for Health in Indiana University School of Nursing, Indianapolis 46202-5107, USA. wshieh@iupui.edu
authors.forename: Carol
authors.initials: C
authors.lastname: Shieh
authors.forename: Melva
authors.initials: M
authors.lastname: Kravitz
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D019970:Cocaine-Related Disorders / Q000517:prevention & control / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006556:Heroin Dependence / Q000517:prevention & control / Q000523:psychology*; D006801:Humans; D002189:Marijuana Abuse / Q000517:prevention & control / Q000523:psychology*; D033261:Maternal-Fetal Relations / Q000523:psychology*; D009042:Motivation; D020380:Needs Assessment; D009511:New England; D015404:Nursing Methodology Research; D009769:Object Attachment; D017063:Outcome Assessment, Health Care; D010044:Outpatient Clinics, Hospital; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control / Q000523:psychology*; D011295:Prenatal Care / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires