3239.0: Monday, November 13, 2000 - 9:06 PM

Abstract #9929

Screening for perinatal substance use in an HMO

Lorraine T. Midanik, PhD1, Mary Anne Armstrong, MA2, Diane M. Carpenter, MPH2, Leslie Lieberman, MSW3, Veronica M. Gonzales, BS2, and Gabriel J. Escobar, MD2. (1) School of Social Welfare, University of California at Berkeley, 120 Haviland Hall, Berkeley, CA 94720-7400, (510) 642-7974, LMidanik@uclink4.berkeley.edu, (2) Division of Research, Kaiser Permanente, 3505 Broadway, Oakland, CA 94611-5714, (3) Regional Nursing, Kaiser Permanente, 1950 Franklin, Oakland, CA 94612

Screening for alcohol and drug use during pregnancy is an important part of perinatal care. We evaluated the efficacy of a self-administered substance use screening questionnaire given to pregnant women who delivered infants between 7/1/95-6/30/98. Questionnaires were compared with in-depth assessments by Early Start (ES) Specialists on whether heavier or abusive levels of substances were detected by the screening instrument. Of the 30,982 who completed the questionnaires, 18% were screened positive for alcohol and drug use. Within this subgroup (n=5,490), 34% met with an ES specialist. Of the women assessed by ES who were positive on the questionnaire (n=1885), 54% were also positively assessed for alcohol and drugs. Of the 567 women who were positive on the questionnaire and negative on the assessment, 9% had a positive toxicology (tox) screen sometime during their pregnancy; 16% who were positive on the questionnaire but did not receive an assessment had a positive tox screen; and 58% who were positive on both the questionnaire and the assessment had a positive tox screen. These findings suggest the importance of followup for women who report substance use on the questionnaire. Given that the majority of women who screened positive were not assessed by ES and that 16% eventually had a positive tox, there is concern for more efforts to provide treatment resources to this population.

Learning Objectives: At the conclusion of this presentation, the participant will appreciate the importance of screening for substance abuse in a pregnant population and will understand the continual need to follow up pregnant women at risk for heavier substance use

Keywords: Substance Abuse Assessment, 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