3239.0: Monday, November 13, 2000 - 9:42 PM

Abstract #8246

Increased follow-up visits in a perinatal substance abuse intervention program reduce NICU admissions

Diane M. Carpenter, MPH1, Mary Anne Armstrong, MA1, 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, 510-450-2067, diane.carpenter@kp.org, (2) Divisional Nursing, Kaiser Permanente, 1950 Franklin St, Oakland, CA 94612, (3) School of Social Welfare, University of California, Berkeley, 120 Haviland Hall, Berkeley, CA 94720-7400

This project evaluated neonatal outcomes across different levels of treatment for substance-abusing pregnant women in the Early Start Program. We identified 1444 women treated by Early Start who delivered infants between 07/01/95-06/30/98. Of these women, 445 (30.8%) were assessed by Early Start but did not show up for follow-up visits; the remaining women (69.2%) assessed by Early Start came in for follow-up: 23.0% had one follow-up visit; 18.5% had two; 12.5% had three; 6.7% had four; and 8.7% had five or more. We compared rates of admission to the neonatal intensive care unit (NICU) among infants of these women. Predictor variables in our logistic model were 1-2, 3-4, and 5 or more follow-up vists, with "assessed only" as the comparison group. We included the following "severity of drug dependence" markers in our model: positive urine toxicology screens for > 1 drug of abuse and a diagnosis of "chemically dependent" rather than "substance abusing". We found that 1-2 follow-up visits was significantly protective against NICU admission (OR=0.68, 95% CI: 0.47-0.98), as was 3-4 follow-ups (OR=0.62, 95% CI: 0.39-0.99). Five or more follow-up visits was protective but not significant. Women testing positive for >1 drug of abuse had infants with higher NICU admission rates (OR=1.84, 95% CI: 1.35-2.52). These results indicate that women with Early Start follow-up visits have significantly lower rates of NICU admission than infants of "assessed only" women, even when controlling for severity of drug dependence.

Learning Objectives: At the conclusion of this presentation, the participant will be able to discuss the impact of amount of treatment for maternal substance abuse on neonatal health

Keywords: Substance Abuse Treatment, Infant Health

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