title: Perinatal outcome of illicit substance use in pregnancy--comparative and contemporary socio-clinical profile in the UK.
abstract: The aim of the study was to determine the contemporary socio-clinical profile and perinatal outcome of illicit substance use in pregnancy in a large UK city and compare with published literature. Cases were identified retrospectively from the 'cause for concern' referrals over 5 years (2003-2007). Data was collected on mother-infant pair from medical notes and laboratory records. Chi-square and Mann-Whitney U tests were used where appropriate for statistical analysis. One hundred sixty-eight women were identified as using illicit substance in pregnancy. Smoking (97.4%), unemployment (85.4%) and single status (42.3%) were frequent. Besides controlled use of methadone, heroin, cannabis and benzodiazepines were the most commonly used drugs. Hepatitis C prevalence was high (29.9%) despite low antenatal screening rates (57.7%). Neonatal morbidity was related to prematurity (22.9%), small for dates (28.6%) and neonatal abstinence syndrome (NAS; 58.9%). By day 5 of life, 95.1% of the babies developing NAS and 96.1% of those requiring pharmacological treatment were symptomatic. Of the infants developing NAS, 31.7% required pharmacological treatment. A total of 82.5% babies went home with their mother, and 21.2% were placed on the Child Protection Register. Only 14.3% were breast feeding at discharge. Illicit substance use in pregnancy continues to be associated with significant maternal and neonatal morbidity, and the socio-clinical profile in this decade appears unchanged in the UK. Hepatitis C prevalence is high, and detection should be improved through targeted antenatal screening. Where facility in the community is unavailable, 5 days of hospital stay is sufficient to safely identify babies at risk of developing NAS. Most babies were discharged home with their mother.
authors.affiliation: Department of Neonatal Medicine, Division of Women and Child Health, ABM University Health Board, Singleton Hospital, Sketty Lane, Swansea SA2 8QA, UK. drnitingoel@yahoo.co.in
authors.forename: Nitin
authors.initials: N
authors.lastname: Goel
authors.forename: Dana
authors.initials: D
authors.lastname: Beasley
authors.forename: Veena
authors.initials: V
authors.lastname: Rajkumar
authors.forename: Sujoy
authors.initials: S
authors.lastname: Banerjee
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008425:Maternal Behavior; D009357:Neonatal Abstinence Syndrome / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology
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