N C Goler1, M A Armstrong, C J Taillac, V M Osejo. 1. Department of Obstetrics and Gynecology, The Permanente Medical Group, Northern California Region, Vallejo, CA 94590-2406, USA. nancy.goler@kp.org
Abstract
OBJECTIVE: To evaluate the impact of Early Start, an obstetric clinic-based prenatal substance abuse treatment program, on perinatal outcomes. STUDY DESIGN: Subjects were 49 985 women who completed Prenatal Substance Abuse Screening Questionnaires at obstetric clinics between 1 January 1999 and 30 June 2003, had urine toxicology screening tests and either live births or intrauterine fetal demises (IUFDs). Four groups were compared: women screened/assessed positive and treated by Early Start ('SAT', n=2073); women screened/assessed positive without treatment ('SA', n=1203); women screened positive only ('S', n=156); controls who screened negative (n=46,553). Ten neonatal and maternal outcomes were studied. RESULT: SAT women had either similar or slightly higher rates than the control women on most outcomes but significantly lower rates than S women. SA women generally had intermediate rates to the SAT and S groups. In multivariate analysis, the S group had significantly worse outcomes than the SAT group: preterm delivery (odds ratio (OR)=2.1, 1.3 to 3.2), placental abruption (OR=6.8, 3.0 to 15.5) and IUFD (OR=16.2, 6.0 to 43.8). CONCLUSION: Substance abuse treatment integrated with prenatal visits was associated with a positive effect on maternal and newborn health.
OBJECTIVE: To evaluate the impact of Early Start, an obstetric clinic-based prenatal substance abuse treatment program, on perinatal outcomes. STUDY DESIGN: Subjects were 49 985 women who completed Prenatal Substance Abuse Screening Questionnaires at obstetric clinics between 1 January 1999 and 30 June 2003, had urine toxicology screening tests and either live births or intrauterine fetal demises (IUFDs). Four groups were compared: women screened/assessed positive and treated by Early Start ('SAT', n=2073); women screened/assessed positive without treatment ('SA', n=1203); women screened positive only ('S', n=156); controls who screened negative (n=46,553). Ten neonatal and maternal outcomes were studied. RESULT: SAT women had either similar or slightly higher rates than the control women on most outcomes but significantly lower rates than S women. SA women generally had intermediate rates to the SAT and S groups. In multivariate analysis, the S group had significantly worse outcomes than the SAT group: preterm delivery (odds ratio (OR)=2.1, 1.3 to 3.2), placental abruption (OR=6.8, 3.0 to 15.5) and IUFD (OR=16.2, 6.0 to 43.8). CONCLUSION: Substance abuse treatment integrated with prenatal visits was associated with a positive effect on maternal and newborn health.
Authors: Abigail H Rizk; Sara E Simonsen; Leissa Roberts; Lisa Taylor-Swanson; Jennifer Berkowicz Lemoine; Marcela Smid Journal: J Midwifery Womens Health Date: 2019-08-12 Impact factor: 2.388
Authors: Kelly C Young-Wolff; Lue-Yen Tucker; Mary Anne Armstrong; Amy Conway; Constance Weisner; Nancy Goler Journal: Matern Child Health J Date: 2020-04
Authors: Doris McGartland Rubio; Nancy L Day; Joseph Conigliaro; Barbara H Hanusa; Cynthia Larkby; Melissa McNeil; Elan Cohen; Bobby Jones; Margaret Watt-Morse; Carol Gilmour; Michelle Lancet; Kevin L Kraemer Journal: J Subst Abuse Treat Date: 2013-10-14
Authors: Mary Anne Armstrong; Lee Ann Kaskutas; Jane Witbrodt; Cosette J Taillac; Yun-Yi Hung; Veronica M Osejo; Gabriel J Escobar Journal: Soc Work Health Care Date: 2009