Author(s): Goel N, Beasley D, Rajkumar V, Banerjee S
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Abstract The aim of the study was to determine the contemporary socio-clinical profile and perinatal outcome of illicit substance use in pregnancy in a large UK city and compare with published literature. Cases were identified retrospectively from the 'cause for concern' referrals over 5 years (2003-2007). Data was collected on mother-infant pair from medical notes and laboratory records. Chi-square and Mann-Whitney U tests were used where appropriate for statistical analysis. One hundred sixty-eight women were identified as using illicit substance in pregnancy. Smoking (97.4\%), unemployment (85.4\%) and single status (42.3\%) were frequent. Besides controlled use of methadone, heroin, cannabis and benzodiazepines were the most commonly used drugs. Hepatitis C prevalence was high (29.9\%) despite low antenatal screening rates (57.7\%). Neonatal morbidity was related to prematurity (22.9\%), small for dates (28.6\%) and neonatal abstinence syndrome (NAS; 58.9\%). By day 5 of life, 95.1\% of the babies developing NAS and 96.1\% of those requiring pharmacological treatment were symptomatic. Of the infants developing NAS, 31.7\% required pharmacological treatment. A total of 82.5\% babies went home with their mother, and 21.2\% were placed on the Child Protection Register. Only 14.3\% were breast feeding at discharge. Illicit substance use in pregnancy continues to be associated with significant maternal and neonatal morbidity, and the socio-clinical profile in this decade appears unchanged in the UK. Hepatitis C prevalence is high, and detection should be improved through targeted antenatal screening. Where facility in the community is unavailable, 5 days of hospital stay is sufficient to safely identify babies at risk of developing NAS. Most babies were discharged home with their mother.
This article was published in Eur J Pediatr
and referenced in Pharmaceutica Analytica Acta