[Multidisciplinary monitoring and psychosocial support reduce complications of opiate dependence in pregnant women: 114 pregnancies].
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.
Brulet
Charlotte
C
Service de gynécologie obstétrique C et de médecine materno-foetale, Hôpital Arnaud de Villeneuve, CHU, Montpellier.
Chanal
Corinne
C
Ravel
Patrice
P
Mazurier
Evelyne
E
Boulot
Pierre
P
Faucherre
Vincent
V
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