The establishment of a cohort of substance using pregnant women and their babies

NDARC Staff

Lucy Burns, Delyse Hutchinson, Joanne Ross, Wendy Swift, Elizabeth Conroy

Other Investigators

Paul Haber (Royal Prince Alfred Hospital and University of Sydney Central Clinical School) and Christine Stephens (Central Sydney Area Health Service Drug Health Services)

Rationale

It is well known that the association between maternal substance use and poor obstetrical outcomes is complicated by the significant physical and psychosocial morbidity associated with substance use disorders. Studies have previously found high exposure to violence, poor physical health, and moderate/severe psychological distress among substance-using pregnant women. These factors are rarely examined together and yet a wholistic picture is necessary to gain an understanding of the health needs of the mother-child (fetus) dyad.

Aims

The aim of the present study was therefore to describe the clinical and psychosocial characteristics of pregnant women attending the substance use antenatal clinic of a large public hospital in Sydney, Australia. This information was collected as a prerequisite to the design of a clinical service that could better meet the needs of both mother and child.

Design and Method

The design is a cross-sectional survey measuring maternal and neonatal health. Face-to-face interviews were conducted with 23 pregnant women known to have a substance use problem. These women were recruited from RPAH Drug Health Services and the specialist antenatal clinic. The interview included questions on obstetric history, obstetric complications, substance use, physical health, mental health, violent victimisation, and health service utilisation.

Benefits

This cohort study will have the potential to answer a number of important policy questions such as what are the patterns and types of drugs used in pregnancy and what constitutes optimal antenatal and postnatal care arrangements for these women. At the broader level it will set the baseline for monitoring the growth and development of a group of potentially 'at risk' children, and for the identification of factors associated both with harm and resilience and 'windows of opportunity' for harm reduction.

Output

A key finding of the study was the low contraceptive use among the women. A follow-on project aimed at identifying barriers to effective contraceptive use and the feasibility of establishing a sexual health clinic for substance using women has recently been funded by NSW Health. Additionally, one paper has been submitted for publication; a second paper is currently in preparation.

Funding

NSW Health Drug and Alcohol Program Research Grants