Mode of Delivery in Drug-Dependent Pregnant Women: A Case Control Study.
Objective. To determine the contribution of drug use during pregnancy to the route of delivery.Methods. A case-control study was conducted at a hospital in Coimbra, Portugal, between 2001 and 2014. Drug-dependent pregnant women (n= 236) were compared with a control group of low risk women (n= 228) in terms of maternal characteristics, obstetric history, pregnancy complications, and labor details. Factors that influenced the mode of delivery were determined. Statistical analysis was performed with SPSS v. 23.0 (IBM Corp.).pvalues < 0.05 were considered statistically significant.Results. Drug-dependent women presented a lower rate of cesarean delivery (18.2 versus 28.9%,p= 0.006). After adjusting for the factors that were significantly related to the mode of delivery, drug dependency influenced the rate of cesarean section (β= 0.567; 95% CI = 0.328-0.980). Within the drug-dependent group, the mode of delivery was significantly related to previous cesarean or vaginal delivery (p= 0.008 andp< 0.001, resp.) and fetal presentation (p< 0.001), but not with the type of drug, route of administration, or substitution maintenance therapy.Conclusions. The drug-dependent group presented a significantly higher rate of vaginal delivery. However, this was not associated with the behavioral factors analyzed. We hypothesize that other social and psychological factors might explain this difference.
Department of Obstetrics B, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Ana Raquel
0000-0002-3417-5736
AR
Neves
Department of Obstetrics B, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Fabiane
F
Neves
Department of Obstetrics B, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Isabel
I
Santos Silva
Department of Obstetrics B, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Maria do Céu
MD
Almeida
Department of Obstetrics B, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Pitorra
P
Monteiro
D000328:Adult; D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy; D011248:Pregnancy Complications; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications*; D055815:Young Adult