Pregnant Women Who Use Substances Can Deliver Healthy Infants With Early Treatment, Study Finds

Main Category: Pregnancy / Obstetrics
Also Included In: Alcohol / Addiction / Illegal Drugs;  Pediatrics / Children's Health
Article Date: 30 Jun 2008 - 1:00 PDT

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Pregnant women with substance abuse problems can have successful pregnancies if they receive treatment early in their pregnancies, according to a Kaiser Permanente study released Thursday, USA Today reports. Women who use illicit drugs, alcohol and tobacco usually are at greater risk than other women for complications during pregnancy.

The study was conducted by Nancy Goler, an ob-gyn at Kaiser Permanente Northern California, and colleagues. Goler says the key to success for the mothers was the approach to care at KPNC where pregnant women with substance abuse issues are provided care in one place. KPNC screens all pregnant women for illicit drug, alcohol and tobacco use. Pregnant women with substance abuse problems can receive counseling with on-site social workers and licensed therapists directly following their regular prenatal care appointments at KPNC.

For the study, the researchers examined a population of 50,000 pregnant women who sought care at KPNC. Of those women, 2,100 women received treatment at KPNC for substance abuse, while 160 women declined such treatment.

The women who received substance abuse treatment during their first trimester were no more likely than the other pregnant women who were not substance abusers to have a preterm delivery, or develop a condition in which the placenta detaches from the uterus, the study found. In addition, women who received substance abuse treatment were no more likely to deliver stillborn or low-birthweight infants or infants who required ventilator care, according to the study.

Goler said combining substance abuse counseling and prenatal care should become the "gold standard" of care for pregnant women. Ashlesha Dayal, a maternal-fetal specialist at Montefiore Medical Center who was not involved in the study, said the "one-stop shopping" approach at KPNC helps prevent women from cancelling appointments and reduces their need to leave work or find child care. However, she added that it could be difficult to duplicate the study's success because most ob-gyns do not have access to therapists and social workers to treat patients with substance abuse problems. In addition, the women who received substance abuse treatment were a "select" group because they agreed to therapy. The study would be stronger if researchers randomly assigned some women to receive coordinated care and some to receive the usual medical care (Szabo, USA Today, 6/26).

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