Maternal and neonatal effects of substance abuse during pregnancy: our ten-year experience.
OBJECTIVE
The aim of the study was to assess perinatal outcome of pregnancy burdened with maternal addiction in comparison with an unselected population from a European transition country.


METHODS
Data on pregnancies complicated by illicit drug abuse (n = 85) managed during a 10-year period (1997-2007) at Split University Hospital were analyzed. Data on the type of drug, course of gestation and labor, and on perinatal outcome were considered. Data on all non-dependence pregnancies recorded during the study period were used as a control group.


RESULTS
During the study period, there were 85 dependence-complicated pregnancies (0.2%). Use of heroin alone during pregnancy was recorded in 51 women (50%), methadone alone in 6 (7%), and a combination of heroin and methadone in 9 (11%). Premature delivery was significantly more common in the group of pregnant addicts (21% vs. 6%); 49% of pregnant addicts were carriers of hepatitis C virus (HCV) and 14% of hepatitis B virus (HBV). Neonatal abstinence syndrome developed in 61 infants (7%) born to addicted mothers. There were 4 cases (4.6%) of early neonatal death; 7 neonates had 5-minute Apgar score < or = 7 (8%); 29 neonates had low birth weight for age (33%); and 7 neonates had congenital anomalies (8%). The risk of various congenital anomalies was 3-fold in the group of children born to addicted mothers.


CONCLUSIONS
Addiction pregnancies present a small but high-risk group according to perinatal outcome. Appropriate obstetric and neonatal care can reduce the rate of complications in these pregnancies and improve perinatal outcome.
Vucinovic
Mirjana
M
Neonatal Intensive Care Unit, Department of Obstetrics and Gynecology, Split University Hospital, Split, Croatia. mirjana.vucinovic@st.t-com.hr
Roje
Damir
D
Vucinovic
Zoran
Z
Capkun
Vesna
V
Bucat
Marija
M
Banovic
Ivo
I
D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D017523:Croatia / Q000453:epidemiology; D005260:Female; D003932:Heroin / Q000009:adverse effects; D006556:Heroin Dependence / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007226:Infant Mortality; D007231:Infant, Newborn; D018811:Maternal Exposure; D008691:Methadone / Q000009:adverse effects / Q000627:therapeutic use; D009357:Neonatal Abstinence Syndrome / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced* / Q000453:epidemiology; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D011256:Pregnancy Outcome
D003932:Heroin; D008691:Methadone