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Perinatal outcome of illicit substance use in pregnancy—comparative and contemporary socio-clinical profile in the UK

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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.

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Acknowledgements

We would like to thank Virginia Hewitt, lead midwife for vulnerable adults and children, for her suggestions in the formative stage of the study and Cerys Nicholls for her help in collecting maternal data. We would like to thank the audit department at Singleton Hospital and Mrs. Lynda Challacombe for their help in obtaining medical notes.

Conflict of interest

The authors declare no conflict of interest.

Author information

Correspondence to Sujoy Banerjee.

Appendix

Appendix

Table 5 Summary points

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Goel, N., Beasley, D., Rajkumar, V. et al. Perinatal outcome of illicit substance use in pregnancy—comparative and contemporary socio-clinical profile in the UK. Eur J Pediatr 170, 199–205 (2011). https://doi.org/10.1007/s00431-010-1284-6

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Keywords

  • Illicit substance use
  • Substance misuse
  • Socio-clinical profile
  • Perinatal outcome
  • Neonatal abstinence syndrome