The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #56017

Ira J. Chasnoff, MD, President, Children's Research Triangle, 180 North Michigan Avenue, Suite 700, Chicago, IL 60601, 312/726-4011, ichasnoff@cr-triangle.org and Ellen Hutchins, ScD, Chief, Perinatal and Women's Health Branch, Maternal and Child Health Bureau, Parklawn Bldg Rm 10C-16, 5600 Fishers Lane, Rockville, MD 20857.

The purpose of this study was to evaluate a new screening instrument, the 4P's Plus, in identifying pregnant women at risk for alcohol or other drug use. Within an initial sample of 2002 Medicaid-eligible pregnant women, we identified three groups of women with increasing levels of risk for alcohol or illicit drug use during pregnancy: 1. <2% risk - those women who have never used alcohol 2. 10% risk - those women who had used alcohol in the past but not in the month before pregnancy 3. 34% risk - those women who used alcohol or cigarettes in the month before pregnancy. We integrated these three factors into a composite instrument, the 4P's Plus, and conducted field tests with 1528 medicaid-eligible pregnant women (80% African American, 20% Hispanic) in Chicago. Women with a positive screen, defined as having used any alcohol or any tobacco in the month prior to knowledge of the pregnancy, underwent a full psychosocial and substance abuse assessment. 411 women acknowledged any alcohol and/or tobacco use in the month before knowledge of pregnancy. Thus 27% had a positive screen for risk of alcohol or other drug use during pregnancy. Of the 411 women with a positive screen, 391 (95%)had a full clinical assessment completed. Of the 391 pregnant women who were assessed, 137 (35%) were found to be actively using alcohol or illicit drugs. These 137 women represented 9% of the overall population of pregnant women screened in the prenatal care clinics.

Learning Objectives:

At the conclusion of the session, participants will be able to do the following:
• List the five questions in the 4 P's Plus.
• Identify pregnant women at risk for alcohol or other drug use during pregnancy.

Keywords: Alcohol Use, Screening Instruments

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.