Pregnancy and addiction. A comprehensive care model.

The problem of substance abuse in pregnancy is a major public health dilemma. Effective comprehensive care of drug addicted women has been shown to improve maternal and neonatal outcomes. The Center for Addiction and Pregnancy (CAP) combines the disciplines of pediatrics, substance abuse treatment, obstetrics/gynecology, and family planning in an effort to reduce the barriers to care often presenting in this subpopulation. For the first 100 CAP births, 82% were delivered vaginally, with a mean gestational age of 38 weeks. The Neonatal Intensive Care Unit admission rate was 10%, and the Bayley Scales of Infant Development performed at 6 and 12 months revealed mean developmental indices within the normal range. In a comparison study, a group of CAP participants had nearly $5,000 savings in costs when compared to a matched cohort. The CAP model of care appears to be an effective mode of treatment for substance abusing pregnant women.