Prevalence of illicit drug use at the end of pregnancy: a cross-sectional study at the time of birth.
BACKGROUND
Drug use during pregnancy is associated with adverse perinatal outcomes. This study was conducted to assess the prevalence of consumption of drugs of abuse in pregnant women at the end of gestation.


METHODS
Cross-sectional study of all consecutive pregnant women in labor admitted to a regional hospital in Calella (Barcelona, Spain) in labor over one year (2014-2015). Women who gave written consent to take part in the study provided a urine sample on admission and completed a questionnaire with toxic-habit-related questions.


RESULTS
The study population included 862 women, 721 (83.6%) of which agreed to participate. Of the 721 urine samples obtained, 719 (99.7%) were valid for analysis. The prevalence of drugs of abuse was 5.4% (N.=39). Cannabis was the most frequently detected substance. No participant tested positive for opioids. In the multivariate analysis, predictors of illicit drug use were history of more than two abortions, premature delivery, self-reporting of consumption during pregnancy, poor obstetric control during gestation, and consideration of vulnerable pregnant woman. Based on the β coefficients of these five factors, a scoring system for discriminating positivity or negativity of drugs of abuse in urine testing was calculated (area under the ROC 0.84).


CONCLUSIONS
The prevalence of consumption of drugs of abuse at the end of pregnancy was 5.4%. A simple test based on five anamnestic variables is useful to discriminate women with positive and negative results of urine testing for drugs of abuse tested in this study.
Service of Pediatrics, Comarcal Sant Jaume de Calella Hospital, Corporació de Salut del Maresme i La Selva (Calella-Barcelona), Barcelona, Spain - aroca@salutms.cat.
Amadeu
A
Roca Comas
IMIM Research Institute, Hospital del Mar, Barcelona, Spain.|CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain.
Joan S
JS
Vila Domènech
Service of Clinical Laboratory, Hospital Comarcal Sant Jaume de Calella, Corporació de Salut del Maresme i La Selva (Calella-Barcelona), Barcelona, Spain.
Joana
J
Massa Solé
Service of Pediatrics, Comarcal Sant Jaume de Calella Hospital, Corporació de Salut del Maresme i La Selva (Calella-Barcelona), Barcelona, Spain.
Patricia
P
Timoneda Paz
Service of Pediatrics, Comarcal Sant Jaume de Calella Hospital, Corporació de Salut del Maresme i La Selva (Calella-Barcelona), Barcelona, Spain.
Mar
M
Peñas Boira
Service of Pediatrics, Comarcal Sant Jaume de Calella Hospital, Corporació de Salut del Maresme i La Selva (Calella-Barcelona), Barcelona, Spain.
Francisco J
FJ
Herrero Espinet
Service of Pediatrics, Comarcal Sant Jaume de Calella Hospital, Corporació de Salut del Maresme i La Selva (Calella-Barcelona), Barcelona, Spain.
Josep
J
Sánchez Jiménez
Service of Pediatrics, Comarcal Sant Jaume de Calella Hospital, Corporació de Salut del Maresme i La Selva (Calella-Barcelona), Barcelona, Spain.
Anna
A
Ballester Martínez
D000028:Abortion, Induced / Q000706:statistics & numerical data; D000328:Adult; D019540:Area Under Curve; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000652:urine; D002189:Marijuana Abuse / Q000453:epidemiology / Q000652:urine; D015999:Multivariate Analysis; D036801:Parturition; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000652:urine; D047928:Premature Birth / Q000453:epidemiology; D011295:Prenatal Care / Q000592:standards; D015995:Prevalence; D057566:Self Report / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D013030:Spain / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000652:urine; D035862:Vulnerable Populations
D013287:Illicit Drugs