title: Triply troubled: criminal behaviour and mental health in a cohort of teenage pregnant substance misusers in treatment.
abstract: BACKGROUND
  Teenage substance misuse and pregnancy are major public health problems in the UK, where the most recent figures on maternal deaths suggest that they have doubled among young substance misusers. In general, little is known about their pregnancy outcomes.
  
  
  OBJECTIVE
  The aims of this study were to describe the characteristics of a sample of teenage pregnant drug users in the UK, to examine their psychosocial risk and complicating factors at presentation, to evaluate adherence to current national guidelines and to assess the adequacy of guidelines in relation to identified characteristics.
  
  
  METHODS
  A six-year records survey of young people attending a specialist adolescent drug misuse service in the west midlands of the UK.
  
  
  RESULTS
  Ten pregnant adolescents were identified from records. These girls have had unstable or abusive experiences through childhood, half having other substance misusers in the family. All were with substantially older partners, who were also substance misusers. All had required a mental health assessment and 90% had a history of self-harm. There were no maternal or neonatal deaths, and only one girl had a miscarriage, but in four cases, the child had to be fostered.
  
  
  CONCLUSIONS
  To our knowledge, this is the first analysis of this kind in the UK. Available guidelines were followed, but our findings suggest that more detailed and comprehensive guidelines are required. Preventive measures through education are likely to be hampered by the early age at which these girls cease attending school.
authors.affiliation: Academic Psychiatric Unit, Keele University Medical School (St George's Hospital Campus), Keele, UK.
authors.forename: Wesley
authors.initials: W
authors.lastname: Barnes
authors.forename: Khaled M K
authors.initials: KM
authors.lastname: Ismail
authors.forename: Ilana B
authors.initials: IB
authors.lastname: Crome
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D057237:Criminals / Q000523:psychology*; D055030:Drug Users / Q000523:psychology*; D004739:England; D005260:Female; D006801:Humans; D008603:Mental Health; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000523:psychology*; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000523:psychology*; D011795:Surveys and Questionnaires