Substance use in HIV-Infected women during pregnancy: self-report versus meconium analysis.
We evaluated prenatal substance use in a cohort of 480 HIV-infected women and their uninfected children. Substance use was reported by 29%; the most common substances reported were tobacco (18%), alcohol (10%), and marijuana (7.2%). Fewer than 4% of women reported cocaine or opiate use. Substance use was more common in the first trimester (25%) than the second (17%) and third (15%) (trend p-value <0.01), and was associated with race/ethnicity, education, birthplace, age and marital status. For 264 mother/infant pairs with meconium results, sensitivity of self-report was 86% for tobacco, 80% for marijuana and 67% for cocaine. Higher discordance between self-report and urine/blood toxicology was observed for cocaine, marijuana and opiates in a non-random subset of mothers/infants with these tests. Findings suggest reasonably complete self-reporting of substance use as confirmed by meconium analysis. Illicit substance use was low and substantially less than that reported in earlier studies of HIV-infected women, but alcohol and tobacco exposure was prevalent.
Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA. ktassiop@hsph.harvard.edu
Katherine
K
Tassiopoulos
Jennifer S
JS
Read
Susan
S
Brogly
Kenneth
K
Rich
Barry
B
Lester
Stephen A
SA
Spector
Ram
R
Yogev
George R
GR
Seage
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D008470:Meconium / Q000737:chemistry*; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011264:Pregnancy Trimesters; D011297:Prenatal Exposure Delayed Effects; D015995:Prevalence; D057566:Self Report; D012959:Socioeconomic Factors; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult