title: [Multidisciplinary monitoring and psychosocial support reduce complications of opiate dependence in pregnant women: 114 pregnancies].
abstract: OBJECTIVE
  Drug abuse during pregnancy is an important public health problem. Montpellier University Hospital established a center for addiction and pregnancy in 1997 to provide multidisciplinary prenatal care aimed at reducing maternal and fetal risks during pregnancy and afterwards. This study assesses the trends in drug-taking behavior and pregnancy outcome among women receiving this prenatal care.
  
  
  METHODS
  This exploratory prospective study examined participants in this program during its first 5 years (1997-2002). Women were included if they had been: pregnant, addicted to opiates, enrolled in the program for at least 15 days, and if their delivery took place at Montpellier Hospital. We recorded how often they came to prenatal care, drug-taking behavior, social and economic level, and obstetrical and neonatal outcomes.
  
  
  RESULTS
  The study included 114 women. Those receiving drug substitution at the onset of pregnancy mainly saw general practitioners (64/89 at the beginning of pregnancy), who most often prescribed buprenorphine (70/105 at the end of pregnancy). More than two thirds of patients (n=78) abused several substances. Heroine abuse decreased (p<0.01) over pregnancy, and social and economic level rose (p<0.001). Mean gestational age at delivery was 38.5 weeks. Neonatal withdrawal syndrome remained an important problem and required treatment in 89 infants (78%). No mothers abandoned their infant.
  
  
  CONCLUSIONS
  Multidisciplinary prenatal care with medical, social, and psychological support can decrease opiate abusers' risks during pregnancy even when the drug treatment program is essentially unsupervised.
authors: Service de gynécologie obstétrique C et de médecine materno-foetale, Hôpital Arnaud de Villeneuve, CHU, Montpellier.
authors: Charlotte
authors: C
authors: Brulet
authors: Corinne
authors: C
authors: Chanal
authors: Patrice
authors: P
authors: Ravel
authors: Evelyne
authors: E
authors: Mazurier
authors: Pierre
authors: P
authors: Boulot
authors: Vincent
authors: V
authors: Faucherre
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000517:prevention & control* / Q000628:therapy; D010348:Patient Care Team; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control* / Q000628:therapy; D011446:Prospective Studies; D012944:Social Support