Substance abuse during pregnancy is a major problem in the United States, with many adverse maternal, fetal, and neonatal effects. We evaluated the effect of Early Start, an obstetric clinic-based perinatal substance abuse treatment program in a Managed Care Organization, on neonatal outcomes. The study cohort included 6,774 Kaiser Permanente members who delivered babies between 07/01/95 and 06/30/98 and completed Early Start Prenatal Substance Abuse Screening Questionnaires. These screeners were electronically linked to Early Start patient assessments and follow-up appointment data, urine toxicology test results, and neonatal outcomes. Women were categorized into 4 groups: (1) substance abusers treated by Early Start (n=782), (2) substance abusers screened by Early Start who had no follow-up treatment (n=348), (3) substance abusers with no Early Start intervention (n=262), and (4) control group with no evidence of substance abuse (n=5,382). Infants of women who were treated by Early Start had assisted ventilation rates (1.5%) similar to control infants (1.4%), but lower than the screened only group (4.0%, p=0.001) and the substance abusers with no Early Start intervention (3.1%, p=0.001). Similar patterns were found for low birth weight and preterm delivery. These patterns persisted in multivariate analyses. Substance abuse treatment for pregnant women as provided by Early Start has a beneficial effect on their newborns. Infants of women treated by Early Start do about as well as control infants on rates of assisted ventilation, low birth weight, and pre-term delivery and have lower rates of these outcomes than infants of substance abusers who are not treated.
Learning Objectives: At the conclusion of the presentation, the participant will be able to describe an evaluation of an innovative perinatal substance abuse treatment program and will be able to assess the applicability of this treatment model to their program.
Keywords: Substance Abuse Treatment, Prenatal Interventions
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: none
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.