3239.0: Monday, November 13, 2000 - 9:24 PM

Abstract #4807

Perinatal substance abuse treatment decreases need for neonatal assisted ventilation

Mary Anne Armstrong, MA1, Diane M. Carpenter, MPH1, Leslie Lieberman, MSW2, Lorraine T. Midanik, PhD3, Veronica M. Gonzales, BS1, and Gabriel J. Escobar, MD1. (1) Division of Research, Kaiser Permanente, 3505 Broadway, Oakland, CA 94611-5714, (510) 450-2226, maa@dor.kaiser.org, (2) Regional Nursing, Kaiser Permanente, 1950 Franklin, Oakland, CA 94612, (3) School of Social Welfare, University of California, Berkeley, 120 Haviland Hall, Berkeley, CA 94720-7400

This study evaluated neonatal outcomes among women served by the Early Start Program, an obstetric clinic-based perinatal substance abuse treatment program in a managed care organization. We identified 30,982 women who delivered infants from 7/95-6/98 and who completed Early Start Prenatal Substance Abuse Screening Questionnaires (screeners). We electronically linked screeners, patient assessments, treatment data, pregnancy toxicology screen (tox) results, and neonatal outcomes. Women were categorized into six groups for comparisons. Women assessed by an Early Start therapist were either (1) assessed positive as substance abusers and had follow-up treatment (n=999) or (2) assessed positive with no treatment (n=445). Women who were not assessed were divided into 4 groups: (3) positive screener and positive tox (n=221), (4) positive screener but no positive tox (n=3,266), (5) negative screener but positive tox (n=293), and (6) negative screener and no positive tox (controls, n=25,758). One outcome evaluated was neonatal assisted ventilation (vent). Infants of treated women had vent rates (1.8%) similar to control infants (2.2%, p=0.5), but infants of untreated women assessed as substance abusers had higher vent rates (3.4%) than controls (p=0.08). Infants of women who screened negative with a positive tox had significantly higher vent rates (6.2%) than either controls (2.2%, p=0.001) or infants of treated women (1.8%, p=0.001). Results for other neonatal outcomes will be presented. Substance abusing women who receive counseling during pregnancy have infants who do almost as well as infants of non-substance abusing women and are less likely to require assisted ventilation than infants of untreated substance abusers.

Learning Objectives: At the conclusion of the presentation, the participant will have learned about 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, Pregnancy

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.

The 128th Annual Meeting of APHA