Substance abuse during pregnancy has consistently been associated with low birth weight, a significant predictor of infant mortality. During the 1990s, substance abuse treatment programs for pregnant women were developed to help reduce maternal drug use, improve access to prenatal care and improve perinatal health outcomes. This study compared health care costs and birth weight for 445 pregnant women who received treatment in five modalities (residential, outpatient, residential/outpatient, methadone and detoxification only)in Massachusetts between 1992 and 1997. Costs and outcomes were assessed through birth certificates, Medicaid claims and treatment records. Multiple regression was used to control for baseline differences between the groups and to identify personal or program components that contribute to higher birth weight at lower costs. Results: Women who received only detoxification had twice the incidence of low birth weight. Although women who received the most intensive treatment(residential/outpatient)delivered the heaviest infants (3072 grams) their total health care expenditures were $17,872 higher than the detox group. Outpatient programs were the most efficient option, producing excellent birth outcomes (3026 grams) at only $1,495 more than detoxification. A second regression used five intermediate treatment outcomes - prenatal care, tobacco use, relapse, weight gain and infection - to clarify ways in which treatment programs influence birth weight. Results suggested that birth weight was influenced primarily through improved nutrition and reduced drug use. Residential settings may have been more effective because they had more control over these behaviors.
Learning Objectives: Participants will learn specific ways in which substance abuse treatment programs influence maternal behavior and infant health, for example, through better nutrition, prenatal care and reduced drug use. The presentation will enable attendees to estimate the cost-effectiveness of various substance treatment modalities, program components and lifestyle changes. The session will be valuable to clinicians in developing and planning more effective programs for pregnant women and their families
Keywords: Perinatal Health, Treatment Outcomes
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.