title: Drugs and pregnancy--outcomes of women engaged with a specialist perinatal outreach addictions service.
abstract: Substance misuse during pregnancy may result in harm to both mother and child. The aims of this study were to assess changes in outcomes of women seen by a specialist perinatal addictions outreach service (1989-1991 versus 2002-2005) and compare outcomes to the local hospital maternity population (2004-2005). A cross-sectional audit of health-care records was conducted comparing the outcomes of women in 2002-2005 with earlier data from 1989-1991 and the local maternity population (2004-2005). The service was attended by 126 women, of whom 83% of opioid-dependent women started/continued opioid maintenance treatment. Of 118 babies delivered, there were two stillbirths and one early neonatal death, 20% were premature, 28% were low birth weight, 21% required the Special Care Baby Unit and 21% of babies born to opioid-dependent mothers were treated for neonatal abstinence syndrome (NAS). Fewer babies required treatment for NAS in 2002-2005 compared to 1989-1991 (21% versus 44%). There were higher rates of miscarriage (3% versus <1%), low birth weight (28% versus 9%) and premature babies (20% versus 9%) compared to the local maternity population (2004-2005). Integrated perinatal addictions treatment may deliver benefits; however, engaging women into treatment earlier and reducing substance use before conception remains the objective.
authors.affiliation: National Addiction Centre, Institute of Psychiatry, King's College London, London, UK. s.mayet@iop.kcl.ac.uk
authors.forename: Soraya
authors.initials: S
authors.lastname: Mayet
authors.forename: Teodora
authors.initials: T
authors.lastname: Groshkova
authors.forename: Louise
authors.initials: L
authors.lastname: Morgan
authors.forename: Tracey
authors.initials: T
authors.lastname: MacCormack
authors.forename: John
authors.initials: J
authors.lastname: Strang
mesh_terms: D016739:Behavior, Addictive / Q000517:prevention & control* / Q000523:psychology / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D006293:Health Promotion; D006801:Humans; D008131:London / Q000453:epidemiology; D008691:Methadone / Q000627:therapeutic use; D018743:Perinatal Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000523:psychology; D011446:Prospective Studies; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology
chemical_list: D008691:Methadone