Treating Substance Abuse Among Pregnant Women

Research at Kaiser Permanente of nearly 50,000 participants showed that pregnant women who receive treatment for substance abuse early in their pregnancy can achieve the same health outcomes as pregnant women with no substance abuse.

The study, which is the largest to date, examined 49,985 women in Kaiser Permanente's prenatal care program and found that integrating substance abuse screening and treatment into routine prenatal care helped pregnant women achieve similar health outcomes as women who were not using cigarettes, alcohol or other drugs. This is also the largest study to examine multiple substances: cigarettes, alcohol, marijuana, methamphetamines, cocaine and heroin.

Pregnancy and Substance Abuse Study Abstract

The aim of this study was to examine fetal and neonatal outcomes in the setting of nuchal translucency (NT) greater than or equal to3 mm at routine first-trimester screening.

A nested case-series study within a retrospective cohort of women screened for Down syndrome at 11-14 weeks of gestation. Crown-rump length, NT values and additional anomalies at first and early second trimesters were recorded. Follow-up information was obtained by a review of medical records and self-report from patients. Adverse outcomes included fetal death and termination of pregnancy due to structural or chromosomal anomalies.

A total of 1930 pregnant women were screened between 11 and 14 weeks of gestation. The prevalence of increased fetal NT (greater than or equal to3 mm) was 1.4% (n=27). Among these, 12 showed increased fetal NT as an isolated finding. In this group, 2 women experienced fetal demise (16% ) and 10 delivered healthy babies. In the group with additional abnormalities (n=15), 9 (60% ) were found to have chromosomal abnormalities, all of which were terminated. For all cases with increased fetal NT, total incidence of adverse outcome was 62%.

At first-trimester ultrasonography, a fetal NT greater than or equal to3 mm was associated with a high incidence of chromosomal abnormalities in the presence of associated abnormalities. For cases with the increased fetal NT at first-trimester fetal assessment and follow-up is necessary to detect possible adverse outcomes.