title: Incidence of narcotic abuse during pregnancy in northwestern Ontario: three-year prospective cohort study.
abstract: OBJECTIVE
  To document the incidence and outcomes of narcotic use during pregnancy in northwestern Ontario.
  
  
  METHODS
  Three-year prospective cohort study.
  
  
  METHODS
  Sioux Lookout and surrounding communities in northwestern Ontario.
  
  
  METHODS
  A total of 1206 consecutive births in a catchment area of 28 000 First Nations patients.
  
  
  METHODS
  Incidence of narcotic use, and maternal and neonatal outcomes.
  
  
  RESULTS
  Incidence of narcotic use in pregnancy has risen to 28.6% (P < .001) and incidence of neonatal abstinence syndrome has fallen to 18.0% of narcotic-exposed births (P = .003). Daily intravenous drug use is now a common pattern of abuse.
  
  
  CONCLUSIONS
  Narcotic abuse in pregnancy has dramatically increased in northwestern Ontario. Neonatal outcomes have improved as a result of a family medicine-based prenatal and obstetric program that includes a narcotic replacement and tapering program.
authors.affiliation: Professor in the Division of Clinical Sciences at the Northern Ontario School of Medicine and a rural physician and clinical researcher in Sioux Lookout, Ont. lkelly@mcmaster.ca.
authors.forename: Len
authors.initials: L
authors.lastname: Kelly
authors.affiliation: Assistant professor at Northern Ontario School of Medicine and rural family physician in Sioux Lookout.
authors.forename: John
authors.initials: J
authors.lastname: Guilfoyle
authors.affiliation: Assistant professor at Northern Ontario School of Medicine and rural family physician in Sioux Lookout.
authors.forename: Joe
authors.initials: J
authors.lastname: Dooley
authors.affiliation: Assistant professor at Northern Ontario School of Medicine and rural family physician in Sioux Lookout.
authors.forename: Irwin
authors.initials: I
authors.lastname: Antone
authors.affiliation: Assistant professor at Northern Ontario School of Medicine and rural family physician in Sioux Lookout.
authors.forename: Lianne
authors.initials: L
authors.lastname: Gerber-Finn
authors.affiliation: Medical student at the University of British Columbia in Prince George.
authors.forename: Roisin
authors.initials: R
authors.lastname: Dooley
authors.affiliation: Research intern at the Sioux Lookout Meno Ya Win Health Centre (SLMHC).
authors.forename: Nicole
authors.initials: N
authors.lastname: Brunton
authors.affiliation: Medical student at the University of Ottawa in Ontario.
authors.forename: Kara
authors.initials: K
authors.lastname: Kakegamuck
authors.affiliation: Research intern at the SLMHC.
authors.forename: Jill
authors.initials: J
authors.lastname: Muileboom
authors.affiliation: Epidemiologist at Kingston General Hospital and in the Department of Community Heath and Epidemiology at Queen's University in Kingston, Ont.
authors.forename: Wilma
authors.initials: W
authors.lastname: Hopman
authors.affiliation: Special Advisor in First Nations Health at the SLMHC at the time of the study.
authors.forename: Helen
authors.initials: H
authors.lastname: Cromarty
authors.affiliation: Vice President of Patient Services and Clinical Research at the SLMHC at the time of the study.
authors.forename: Barb
authors.initials: B
authors.lastname: Linkewich
authors.affiliation: Vice President of Quality and Clinical Support Services at the SLMHC.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Maki
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000208:ethnology; D009294:Narcotics / Q000633:toxicity; D009357:Neonatal Abstinence Syndrome / Q000453:epidemiology; D009864:Ontario / Q000453:epidemiology; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology
chemical_list: D009294:Narcotics