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Official websites use. Share sensitive information only on official, secure websites. Corresponding author: Sarah H. Heil, Rm. Prospect St. The aim of the present study was to estimate the prevalence of unintended pregnancy and its three subtypes mistimed, unwanted, ambivalent among opioid-abusing women. Interventions are sorely needed to address the extremely high rate of unintended pregnancy among opioid-abusing women. Drug treatment programs are likely to be an important setting for such interventions. Licit and illicit opioid dependence during pregnancy is often complicated by a multitude of other factors, including low socioeconomic status, poor nutrition, lack of prenatal care, family instability, interpersonal violence, homelessness, psychological problems, and other drug use Center for Substance Abuse Treatment, In the perinatal period, these intertwined factors can contribute to a number of adverse maternal and infant outcomes including, but not limited to, premature delivery, low birth weight, and neonatal abstinence syndrome see Kaltenbach et al. In the longer term, bearing a child in such disadvantaged circumstances has been shown to significantly diminish the future wellbeing of both the mother and the child Graham , ; Mishel et al. Further compounding these difficult circumstances, opioid-dependent women become pregnant more often than women in the general population. To our knowledge, there is just one small study estimating unintended pregnancy among opioid-dependent women. As a first step toward developing interventions to reduce unintended pregnancy among opioid-dependent women, the present study sought to estimate the prevalence of unintended pregnancy and its three subtypes mistimed, unwanted, and ambivalent in a much larger sample of pregnant women reporting opioid abuse. This multi-site trial, performed at eight diverse U. Participants who provided informed consent were screened for eligibility either at the time of treatment entry or at the time they considered a change from their established drug treatment program. Interviews were conducted with all potential participants to determine eligibility for the study; at some sites, some information was collected by chart review prior to the interview. Demographic information collected included age, education level, race, and marital status. Drug use and treatment variables assessed included frequency of current opioid and cocaine use and the number and type of prior treatment episodes. Two types of analyses were performed to examine between-group differences. First, analyses examined demographic differences between women with intended pregnancies and women with unintended pregnancies. Statistically significant differences in continuous and dichotomous variables were evaluated using t-tests, and z-tests, respectively. Second, differences between groups on drug use and other factors were evaluated using logistic regression models in which each variable of interest was entered separately into a logit model controlling for age, race and site location. No significant differences were observed on the 5 maternal demographic characteristics compared between women with intended vs. Unintended pregnancy was highly prevalent in this sample; nearly 9 of every 10 women screened reported that the current pregnancy was unintended. This rate is 2—3 times the rate observed in the general population Chandra et al. To our knowledge, this is the first report of the rates of the three subtypes of unintended pregnancy in opioid-abusing pregnant women. The percentage of women reporting mistimed, unwanted or ambivalent pregnancies in the present sample were fairly comparable, with each representing about one-third of the total sample. The percentage of women reporting an unwanted pregnancy was nearly 3 times higher in the present study compared to the general population and the percentage of women reporting ambivalence, more than 4 times higher Mohllajee et al. These figures dramatically underscore the need to develop interventions to bring contraceptive use in line with conception desires among opioid-abusing women. Although there were few differences between women with intended vs. A lower percentage of these women also reported recent cocaine use compared to women with intended pregnancies. Women with ambivalent pregnancies were also more likely to be unemployed and a higher percentage reported prior medication-assisted treatment. Overall, the greatest number of differences was observed between women with ambivalent vs. This is in contrast to the general population literature, where women with ambivalent pregnancies tend to be most similar to women with intended pregnancies in terms of demographic characteristics as well as maternal and infant outcomes Mohlajee et al. Additional studies will be needed to replicate this pattern of results and to determine the implications of such differences. These data suggest that drug abuse treatment programs may be an important setting for interventions to reduce the very high rate of unintended pregnancy in this population. One strategy for doing so involved integrating free family planning services into drug treatment programs. These findings suggest that this is a promising model that should be further developed and rigorously tested as part of efforts to reduce unintended pregnancy among drug-abusing women. The present study has notable strengths. The data were systematically collected across eight diverse U. The study also has limitations. The format of the pregnancy intention question differed from the format used in national surveys e. Also, it is possible that women who were screened for potential study participation may not be representative of the larger population of opioid-dependent women. Nevertheless, the results of the present study clearly document the extremely high rate of unintended pregnancy among a large sample of opioid-abusing women and underscore the need for a greater scientific attention to this serious problem. We thank Laura Garnier for assistance with statistical analyses. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. As a library, NLM provides access to scientific literature. J Subst Abuse Treat. Published in final edited form as: J Subst Abuse Treat. Find articles by Sarah H Heil. Hendree E Jones , Ph. Find articles by Hendree E Jones. Amelia Arria , Ph. Find articles by Amelia Arria. Karol Kaltenbach , Ph. Find articles by Karol Kaltenbach. Mara Coyle , M. Find articles by Mara Coyle. Gabriele Fischer , M. Find articles by Gabriele Fischer. Susan Stine , M. Find articles by Susan Stine. Peter Selby , M. Find articles by Peter Selby. Peter R Martin , M. Find articles by Peter R Martin. Issue date Mar. PMC Copyright notice. The publisher's version of this article is available at J Subst Abuse Treat. Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Mean SD number of times treated for drug abuse in lifetime. Mean SD years of age at 1 st medication-assisted treatment.

The effects of maternal cocaine abuse on mothers and newborns

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Recent studies indicate a complex picture of the effects of maternal cocaine abuse with the majority of negative outcomes a result of dose response effects and cumulative risk factors. This paper reviews recent research within a historic perspective and provide an overview of current knowledge of perinatal outcomes, including neurobehavioral effects and the effect of treatment on mothers and newborns. This is a preview of subscription content, log in via an institution to check access. Rent this article via DeepDyve. Institutional subscriptions. Lyons P, Rittner B: The construction of the crack babies phenomenon as a social problem. American Journal of Orthopsychiatry , , 68 2 — This paper provides an excellent discussion of the development of the misperceptions and misunderstandings associated with prenatal cocaine exposure. Zero to Three , , 13 :1—5. Google Scholar. Neurobehav Toxicol Teratol , 9 — Am J Obstet Gynecol , — Journal of Pediatrics , , — JAMA , — Dixon SD, Bejar R: Echoencephalographic findings in neonates associated with maternal cocaine and methamphetamine use: incidence and clinical correlates. J Pediatr , — New Engl J Med , — Brody JE: Cocaine: litany of fetal risk grows. New York Times. September 6, C1. Clin Perinatol , 26 — This paper provides a through review of studies investigating the development of infants prenatally exposed to cocaine. Tronick EZ, Beeghly M: Prenatal cocaine exposure, child development, and the comprising effects of cumulative risk. Coles CD: Saying 'goodbye' to the 'crack baby'. Neurotoxicol Teratol , 15 — Neuspiel DR: Cocaine and the fetus: mythology of severe risk. Teratology , 44 — Ann N Y Acad Sci , — Bauer C: Maternal Lifestyles Study: effects of substance exposure during pregnancy on acute maternal outcomes. New York Academy of Sciences Conference. Washington, DC; September 16—19, Bauer C: Maternal Lifestyles Study: effects of substance exposure during pregnancy on acute infant outcomes. Interactive and dose effects on health and growth. Pediatrics , — This is a well-designed prospective study that examined the effects of prenatal cocaine use on pregnancy outcomes. J Perinatol , 18 — This study is the first study to examine the association between level of in utero cocaine exposure and cranial ultrasound findings. Bendersky M, Lewis M: Effects of intraventricular hemorrhage and other medical and environmental risks on multiple outcomes at age three years. J Development Behav Pediatr , 16 — CAS Google Scholar. In Clinics in Developmental Medicine, No. London: Spastics International Medical Publications; Lester BM: Data analysis and prediction. In Neonatal Behavioral Assessment Scale. Edited by Brazelton TB. London: Spastics International Medical Publications, — Clin Chem , 35 — Neurotoxicol Teratol , 21 — J Nerv Ment Dis , 8 — J Psychoactive Drugs , 27 — Stevens SJ, Arbiter N: A therapeutic community for substance abusing pregnant women and women with children: Process and outcome. J Substance Treat , 16 — Kaltenbach K, Finnegan LP: Prevention and treatment issues for pregnant cocaine-dependent women and their infants. Comfort ML, Kaltenbach K: Biopsychosocial characteristics and treatment outcomes of pregnant cocaine-dependent women in residential and outpatient substance abuse treatment. J Psychoactive Drugs , 31 — Am J Drug Alcohol Abuse , 25 — Obstet Gynecol , 74 — Obstet Gynecol , 92 — This is a large study that examined the effect of prenatal care and drug treatment on the outcome of cocaine-exposed pregnancies. Article PubMed Google Scholar. Download references. You can also search for this author in PubMed Google Scholar. Reprints and permissions. Kaltenbach, K. The effects of maternal cocaine abuse on mothers and newborns. Curr Psychiatry Rep 2 , — Download citation. Issue Date : December Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Home Current Psychiatry Reports Article The effects of maternal cocaine abuse on mothers and newborns Published: December Volume 2 , pages —, Cite this article. Current Psychiatry Reports Aims and scope Submit manuscript. Abstract Recent studies indicate a complex picture of the effects of maternal cocaine abuse with the majority of negative outcomes a result of dose response effects and cumulative risk factors. Access this article Log in via an institution. Maternal, fetal and neonatal consequences associated with the use of crack cocaine during the gestational period: a systematic review and meta-analysis Article 27 June Rights and permissions Reprints and permissions. About this article Cite this article Kaltenbach, K. Copy to clipboard. Search Search by keyword or author Search. Navigation Find a journal Publish with us Track your research.

Kaltenbach buy cocaine