title: Predictors of inadequate prenatal care in methamphetamine-using mothers in New Zealand and the United States.
abstract: This study compared patterns of prenatal care among mothers who used methamphetamine (MA) during pregnancy and non-using mothers in the US and New Zealand (NZ), and evaluated associations among maternal drug use, child protective services (CPS) referral, and inadequate prenatal care in both countries. The sample consisted of 182 mothers in the MA-Exposed and 196 in the Comparison groups in the US, and 107 mothers in the MA-Exposed and 112 in the Comparison groups in NZ. Positive toxicology results and/or maternal report of MA use during pregnancy were used to identify MA use. Information about sociodemographics, prenatal care and prenatal substance use was collected by maternal interview. MA-use during pregnancy is associated with lower socioeconomic status, single marital status, and CPS referral in both NZ and the US. Compared to their non-using counterparts, MA-using mothers in the US had significantly higher rates of inadequate prenatal care. No association was found between inadequate care and MA-use in NZ. In the US, inadequate prenatal care was associated with CPS referral, but not in NZ. Referral to CPS for drug use only composed 40 % of all referrals in the US, but only 15 % of referrals in NZ. In our study population, prenatal MA-use and CPS referral eclipse maternal sociodemographics in explanatory power for inadequate prenatal care. The predominant effect of CPS referral in the US is especially interesting, and should encourage further research on whether the US policy of mandatory reporting discourages drug-using mothers from seeking antenatal care.
authors.affiliation: Brown Center for the Study of Children at Risk, Warren Alpert Medical School at Brown University and Women and Infants Hospital, Providence, RI, USA. min_wu@hms.harvard.edu
authors.forename: Min
authors.initials: M
authors.lastname: Wu
authors.forename: Linda L
authors.initials: LL
authors.lastname: Lagasse
authors.forename: Trecia A
authors.initials: TA
authors.lastname: Wouldes
authors.forename: Amelia M
authors.initials: AM
authors.lastname: Arria
authors.forename: Tara
authors.initials: T
authors.lastname: Wilcox
authors.forename: Chris
authors.initials: C
authors.lastname: Derauf
authors.forename: Elana
authors.initials: E
authors.lastname: Newman
authors.forename: Rizwan
authors.initials: R
authors.lastname: Shah
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Smith
authors.forename: Charles R
authors.initials: CR
authors.lastname: Neal
authors.forename: Marilyn A
authors.initials: MA
authors.lastname: Huestis
authors.forename: Sheri
authors.initials: S
authors.lastname: Dellagrotta
authors.forename: Barry M
authors.initials: BM
authors.lastname: Lester
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D002669:Child Welfare / Q000208:ethnology / Q000706:statistics & numerical data; D003431:Cross-Cultural Comparison; D005191:Family Characteristics; D005260:Female; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008694:Methamphetamine / Q000008:administration & dosage / Q000009:adverse effects*; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D009520:New Zealand / Q000453:epidemiology; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine