title: Comprehensive treatment program for pregnant substance users in a family medicine clinic.
abstract: OBJECTIVE
  Substance use during pregnancy is a substantial public health problem and a risk factor for poor neonatal outcomes. Prenatal care is often provided in high-risk pregnancy units, separate from addiction treatment.
  
  
  OBJECTIVE
  To provide comprehensive prenatal care and addiction treatment in a family medicine setting.
  
  
  METHODS
  The Toronto Centre for Substance Use in Pregnancy (T-CUP) is a family medicine-based program in a large urban city in Ontario. The T-CUP program comprises an interdisciplinary team using a one-stop access model to provide comprehensive services for pregnant women with a history of alcohol or drug abuse, including prenatal and postnatal medical care, addiction counseling, and assistance with complex psychosocial needs.
  
  
  RESULTS
  A retrospective chart review was performed, including charts for 121 women who received care at T-CUP from August 2000 to January 2006. Women demonstrated a high compliance rate with prenatal care attendance. Most women reported reduction in a variety of drug use categories. Significant differences were found especially among women who presented earlier in their pregnancies (P < .05). As a result, neonatal outcomes were satisfactory and approximately 75% of newborns were discharged home in the care of their mothers.
  
  
  CONCLUSIONS
  Pregnant substance-using women have positive maternal and infant health outcomes when they receive comprehensive care in a family medicine setting.
authors.affiliation: Toronto Centre for Substance Use in Pregnancy, St Joseph's Health Centre, Toronto, ON. ordeaa@stjoe.on.ca
authors.forename: Alice
authors.initials: A
authors.lastname: Ordean
authors.forename: Meldon
authors.initials: M
authors.lastname: Kahan
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding; D002585:Cesarean Section; D016009:Chi-Square Distribution; D005194:Family Practice; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology; D040261:Harm Reduction; D006556:Heroin Dependence / Q000150:complications; D006801:Humans; D007231:Infant, Newborn; D009357:Neonatal Abstinence Syndrome / Q000453:epidemiology*; D009864:Ontario / Q000453:epidemiology; D010349:Patient Compliance; D011181:Postnatal Care; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011256:Pregnancy Outcome; D011295:Prenatal Care; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000628:therapy*; D055815:Young Adult
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