title: Short-term outcomes of infants of substance-using mothers admitted to neonatal intensive care units in New South Wales and the Australian Capital Territory.
abstract: 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.
authors.affiliation: Department of Newborn Care, Royal Hospital for Women, Randwick, Victoria, Australia.
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Abdel-Latif
authors.forename: Barbara
authors.initials: B
authors.lastname: Bajuk
authors.forename: Kei
authors.initials: K
authors.lastname: Lui
authors.forename: Julee
authors.initials: J
authors.lastname: Oei
mesh_terms: 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