Evidenced-based guidelines for the management and care of pregnant substance-abusing women and drug exposed neonates


Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

5122.0: Wednesday, December 14, 2005 - 1:23 PM

Abstract #103620

Judith Morales, MSW, LCSW, CPAS¹, Ilise Zimmerman, MPH, MS¹, and Pamela S. Martin, RNC MSN APNC². (1) Perinatal Addiction Prevention Project, Northern New Jersey Maternal/Child Health Consortium, 17 Arcadian Way, Suite 204, Paramus, NJ 07652, 201-843-7400, jmorales@nnjm-chc.org, (2) Maternity Services, Atlantic Health System, 100 Madison Avenue, Morristown, NJ 07962

The Perinatal Addiction Prevention Project of the Northern New Jersey Maternal/Child Health Consortium, identified the fact that health care providers do not have standard guidelines for the care of pregnant substance abusing women in the acute care setting. In response to this need, an interdisciplinary committee experienced in treating substance-abusing pregnant women was convened. In an effort to improve pregnancy outcomes in the health care delivery environment, evidence-based guidelines focusing on the screening, assessment and treatment of substance-abusing pregnant women and their neonates were authored. Physicians who are renowned experts in the fields of addictions, obstetrics and neonatology reviewed and approved the guidelines. Guideline titles: 1) Substance abuse screening in obstetrics: includes screening using a standardized tool for pregnant women, signs and symptoms of withdrawal, obstetrical complications, scientific explanations for positive urine toxicology, as well as how to effectively screen women to elicit an honest response. 2) Pain management for the chemically dependent pregnant woman: includes pain assessment, non-pharmacological comfort measures, analgesia for labor, anesthesia for surgery, prevention of withdrawal. 3) Methadone intervention for the chemically dependent woman in labor and delivery/postpartum: includes treatment for heroin dependent patients not currently enrolled in a methadone treatment program and those who are currently enrolled. 4) The medical management and care of the drug exposed neonate: includes appropriate nursery environment, assessment, screening, neonatal abstinence syndrome, pharmacological treatment options. Initial evalution by obstetrical and neonatal health care providers indicate that guideline implementation improve pregnancy outcomes in addition to increased provider and client satisfaction.

Learning Objectives:

The participant will be able to

1.Recognize the importance of using a standardized substance abuse screening tool specific to pregnant women
2.Articulate how to screen for risk of all pregnant women as part of a comprehensive medical/nursing evaluation
3.Assess and treat pain in the chemically dependent woman in labor and/or postpartum
4.Describe the pharmacological interventions for safe and effective analgesia for the opiate addicted woman in labor and/or postpartum
5.Develop an appropriate nursery environment, comprehensive assessments, pharmacological interventions, and clinical diagnostic studies for neonates exposed to alcohol and other drugs

Keywords: Assessments, Treatment

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Evidence-based Policy and Practice: New Directions for Improving Pregnancy Outcomes

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA