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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Thomas M. Brady, PhD1, Wendy A. Visscher, PhD2, Moshe Feder, DSc2, and Allison M. Burns2. (1) Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Parklawn Bldg, 5600 Fishers Lane, Suite 16-105, Rockville, MD 20857, (301) 443-9049, tbrady@samhsa.gov, (2) Research Triangle Institute, 3040 Cornwallis Road, Research Triangle Park, NC 27709
In the turbulent life of drug dependence, the care-seeking behavior of women is often impaired. Because drug-dependent women may neglect their general health, their adherence to prenatal care is often problematic due to a variety of social, medical, obstetrical, and psychiatric issues. This paper explores the role of drug use as a barrier to the early initiation of prenatal care. The study data were collected from eight participating hospitals in the Washington, DC, Metropolitan Area Drug Study (DC*MADS). An estimated 12.2% of the women in this sample initiated prenatal care in their third trimester or received no prenatal care. After adjusting for age, race, education, multiparity, and attitudes toward pregnancy, cocaine use was strongly associated with the timing of late prenatal care (odds ratio [OR]=0.28; 95% confidence interval [CI], 0.16-0.51; 1 df; CHI-SQ=18.04; P < 0.0001.) Using a multivariable ordinal logistic regression, the data suggest significant barriers to prenatal care for women substance abusers, especially women who use cocaine. This aversion to utilizing existing health care resources has important policy implications. Increasing access to prenatal care continues to be an important public health policy objective in urban areas, particularly where substance abuse is prevalent. Specific approaches need to be tailored to pregnant women who use drugs in order to successfully engage them in both prenatal care and substance abuse treatment. This study was supported in part by contract 283-99-9018 from the Office of Applied Studies at the Substance Abuse and Mental Health Services Administration and contract 271-89-8340 from the Division of Epidemiology and Prevention Research at the National Institute on Drug Abuse.
Learning Objectives:
Presenting author's disclosure statement:
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.