Short-term outcomes of infants of substance-using mothers admitted to neonatal intensive care units in New South Wales and the Australian Capital Territory.
OBJECTIVE
Illicit substance use during pregnancy is associated with an increased rate of perinatal complications. Our study examines if outcome of infants of substance-using mothers (ISMs) in the neonatal intensive care unit (NICU) setting is similar to unexposed infants (controls).


METHODS
A prospective state-wide NICU study comparing ISMs to control infants admitted to 10 NICUs during a 3-years period (2001-2003). An ISM was defined as an infant whose mother admitted to or was documented to have used substances of dependency (illicit or otherwise) during this pregnancy.


RESULTS
There was a preponderance towards prematurity with ISMs comprising 5.1% (n=310) of 6120 high risk infants (6.2% (n=165) <32 weeks gestation and 6.8% (n=39) of 22-26 weeks gestation). More ISMs were outborn and had significantly lower mortality rate, particularly in the <32 week gestation subgroup (adjusted OR 0.517 95% CI 0.277-0.962, P<0.037). ISMs also demonstrated a non-significant trend towards an increased risk of neonatal morbidities. The pattern of rural and urban substance use was different, with a higher incidence of opiate use (49.3% vs. 26.9%, P<0.001) in urban areas. Most opiate using mothers (85.6%), irrespective of rural or urban residence, were enrolled in methadone programmes. ISMs had a higher incidence of antepartum haemorrhage and chorioamnionitis and fewer were given antenatal steroids.


CONCLUSIONS
ISMs are common in the high-risk NICU population. Further studies are needed to confirm the lower mortality rate and long-term outcomes in these infants.
Abdel-Latif
Mohamed E
ME
Department of Newborn Care, Royal Hospital for Women, Randwick, Victoria, Australia.
Bajuk
Barbara
B
Lui
Kei
K
Oei
Julee
J
D000328:Adult; D020958:Australian Capital Territory; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D009035:Mothers; D009517:New South Wales; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D019966:Substance-Related Disorders