Guidelines for the Management of Pregnant Women With Substance Use Disorders

McLafferty, Laura P.; Becker, Mark P.; Dresner, Nehama; Meltzer‐Brody, Samantha; Gopalan, Priya; Glance, Jody; Victor, Guitelle St.; Mittal, Leena; Marshalek, Patrick; Lander, Laura R.; Worley, Linda L.M.

doi:10.1016/j.psym.2015.12.001

Cited by 47 publications

(16 citation statements)

References 119 publications

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“…159,168 Screening for substance use in pregnancy Expert panels and organization guidelines recommend universal screening for substance use in pregnancy. 72,[169][170][171][172] There are several barriers to routine screening including resource limitations and health care provider attitudes. [173][174][175] Health providers often hold stigmatizing views of women who use substances in pregnancy.…”

Section: Methamphetaminementioning

confidence: 99%

Substance use in pregnancy: The medical challenge

Louw

2018

Obstet Med

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Substance use contributes significantly to the global burden of disease. Growing numbers of women use nicotine, alcohol, and illicit substances. Women are the most vulnerable to problematic substance use in their reproductive years. The first 1000 days of life, starting at conception, have been established as a critical window of time for long-term health and development. Substance use in pregnancy is associated with negative pregnancy and child health outcomes. The impact of antenatal substance use on these outcomes needs to be considered within a challenging and complex context. This review provides an overview of the current literature on the impact of substances on pregnancy and child outcomes as well as the evidence and guidelines on screening and interventions for women using substances during pregnancy.

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Section: Methamphetaminementioning

confidence: 99%

Substance use in pregnancy: The medical challenge

Louw

2018

Obstet Med

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“…Furthermore, the use of different definitions and instruments to assess this outcome hinders result comparability. Studies assessing alcoholic drink intake during pregnancy report prevalence varying between 10.8% and 29.0%, [8][9][10][11] with most frequent intake among pregnant women aged over 30 years, 8,11 tobacco smokers, 10 illicit drug users, 10,12 women with depression13 and those having fewer prenatal care attendances. 11 In view of the risks to which fetuses and pregnant women are exposed,owing to alcohol intake during pregnancy, as well as the scarcity of studies on this subject in Brazil, the purpose of this paper is to assess alcohol intake prevalence and associated factors during pregnancy, as well as excessive intake and types of drink consumed during pregnancy, among parturient women in the municipality of Rio Grande-RS in the year 2013.…”

Section: Introductionmentioning

confidence: 99%

Alcohol intake during pregnancy among parturients in southern Brazil

Meucci

Saavedra

Silva

et al. 2017

Rev. Bras. Saude Mater. Infant.

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Objectives: to assess alcohol intake prevalence and identify associated factors among pregnant women in the municipality of Rio Grande, RS, Brazil. Methods: this was a crosssectional study which included all parturient women residing in the municipality who gave birth in 2013. Two outcomes were characterized: alcohol intake during pregnancy and excessive alcohol intake during pregnancy. In the analysis, proportions were tested using the Chisquare test, whilst Poisson regression was used in the multivariate analysis. Results: 9.4% (CI95%= 8.210.5) of the 2,685 parturient women studied reported having consumed alcohol during pregnancy, with beer being most common beverage. Following adjustment, the factors associated with alcohol intake in pregnancy were: age ≥30 years, brown skin colour, living without a partner, low schooling, tobacco smoking and illicit drug use, having had more children and late onset of prenatal care. Excessive alcohol intake was found in 12.7% (CI95%= 8.616.9) of those who reported drinking during pregnancy and the factors associated with this practice were age ≥30 years, lower schooling and illicit drug use. Conclusions: this study found high alcohol intake during the gestation period and identified women more susceptible to this practice. There is an evident need for health professionals to work on preventing and handling alcohol intake among pregnant women in the municipality

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“…Previous studies on prenatal psychosocial interventions for women using illicit drugs have also failed to display greater abstinence in comparison to control conditions (Terplan et al 2015). A few studies concerning brief interventions and integrated treatment approaches for pregnant women with substance use disorders have shown some promise in reducing fetal substance exposure (Farr et al 2014;Haug et al 2014;McLafferty et al 2016). However, the problem remains that substance using pregnant women rarely receive adequate prenatal care (Kotelchuck et al 2017).…”

Section: Discussionmentioning

confidence: 99%

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

Jussila

Pajulo

Ekholm

2019

Matern Child Health J

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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.

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Guidelines for the Management of Pregnant Women With Substance Use Disorders

Cited by 47 publications

References 119 publications

Substance use in pregnancy: The medical challenge

Substance use in pregnancy: The medical challenge

Alcohol intake during pregnancy among parturients in southern Brazil

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

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