A Novel 4D Ultrasound Parenting Intervention for Substance Using Pregnant Women in Finland: Participation in Obstetric Care, Fetal Drug Exposure, and Perinatal Outcomes in a Randomized Controlled Trial

Abstract

Objectives The aim of the study was to explore the effect of a new prenatal intervention on participation in obstetric care, fetal drug exposure, and perinatal outcomes among substance using pregnant women in Finland. Methods The participants were 90 women referred to a hospital obstetric outpatient clinic due to current or recent substance use. The intervention group (n = 46) was offered three interactive ultrasounds at 24, 30 and 34 gestational weeks and a pregnancy diary accompanied by three prenatal infant mental health consultations. The intervention elements were designed to enhance parental mentalization and prenatal attachment. A randomized control group (n = 44) design was used. All participants were offered treatment-as-usual in the obstetric tertiary setting. Medical record data and meconium toxicology were analyzed. Results The retention rate in the whole sample was 89%. Retention was higher in the intervention group (96% vs. 82%, p < 0.05), of which 74% attended all three ultrasound sessions. However, the pregnant women in the intervention group participated less often in all the scheduled obstetric standard care visits (59% vs. 83%, p = 0.02). Fetal drug exposure and perinatal outcomes were similar in both groups. Within the whole sample, 13% of the neonates were preterm, 12% small for gestational age and 7% had exposure to drugs. Conclusions for Practice Retention in the intervention was very good. Watching the fetus with parenting focus seemed to motivate these high-risk women. Interestingly, the pregnant women in the intervention group tended to prefer the intervention sessions to the routine care. Clinical implications of this finding are discussed. Trial Registry The trial registration number in ClinicalTrials.gov: NCT03413631.

The Elephant in the Room: A Systematic Review of the Application and Effects of Psychological Treatments for Pregnant Women with Dual Pathology (Mental Health and Substance-Related Disorders)

“…Finally, it is worth noting that a great number of studies addressing substance use with RCTs also consider other aspects of the well-being of pregnant women, such as family cohabitation, employment integration, and accessibility to healthcare resources. However, they do not report measures of psychopathology; hence, it cannot be considered that they address dual pathology [38,47,52,57,58,67,68,76,79,85,88,90].…”

Reducing Prenatal Alcohol Exposure and the Incidence of FASD: Is the Past Prologue?

“…Jussila et al conducted a novel, randomized controlled trial among pregnant women attending an obstetric outpatient clinic in Finland. 43 Ninety women were referred to the clinic because of current or recent substance use—defined as self-reported or documented illicit substance use, abuse of prescription medication or alcohol within the past 3 years or during a previous pregnancy, and/or a score of 3 or higher on the Tolerance-Worry-Eye-Opener-Annoy-Cut-Down (TWEAK) alcohol screening tool. They were randomized either to a control group ( n = 44) receiving treatment as usual or to an intervention group ( n = 46) that included interactive use of 4D ultrasound visualization of the fetus at 24, 30, and 34 weeks and a pregnancy diary.…”

Effects of Fetal Images Produced in Virtual Reality on Maternal-Fetal Attachment: Randomized Controlled Trial

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