Validation of the 4P's Plus screen for substance use in pregnancy validation of the 4P's Plus.
OBJECTIVE
The purpose of this study is to validate the 4P's Plus screen for substance use in pregnancy.


METHODS
A total of 228 pregnant women enrolled in prenatal care underwent screening with the 4P's Plus and received a follow-up clinical assessment for substance use. Statistical analyses regarding reliability, sensitivity, specificity, and positive and negative predictive validity of the 4Ps Plus were conducted.


RESULTS
The overall reliability for the five-item measure was 0.62. Seventy-four (32.5%) of the women had a positive screen. Sensitivity and specificity were very good, at 87 and 76%, respectively. Positive predictive validity was low (36%), but negative predictive validity was quite high (97%). Of the 31 women who had a positive clinical assessment, 45% were using less than 1 day per week.


CONCLUSIONS
The 4P's Plus reliably and effectively screens pregnant women for risk of substance use, including those women typically missed by other perinatal screening methodologies.
Chasnoff
I J
IJ
Children's Research Triangle, Chicago, IL 60601, USA. ichasnoff@cr-triangle.org
Wells
A M
AM
McGourty
R F
RF
Bailey
L K
LK
D000328:Adult; D000434:Alcoholic Beverages; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008403:Mass Screening / Q000379:methods; D011237:Predictive Value of Tests; D011247:Pregnancy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000175:diagnosis*