Prevalence of Drug Use in Pregnant West Virginia Patients

Michael L Stitely , Byron Calhoun, Stefan Maxwell, Robert Nerhood, David Chaffin

First Published: 04 September 2010 DIO: https://pubmed.ncbi.nlm.nih.gov/21932753/

Department of Obstetrics and Gynecology West Virginia University School of Medicine, USA.

Abstract

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Introduction: Substance abuse in pregnancy is of serious concern to society and health care providers caring for pregnant women and their infants. Various studies have suggested a prevalence of 10 -20%. This study used an anonymous sampling of umbilical cord tissue to estimate the prevalence of substance abuse in West Virginia.

Methods: For the period of August 2009, as many umbilical cord samples as possible were collected at 8 regionally diverse hospitals in West Virginia. The cord tissue samples were then assayed for amphetamines, cocaine, opiates, marijuana, benzodiazepines, methadone, buprenorphine, and alcohol.

Results: 146 of 759 collected (19.2%) were positive for drugs or alcohol. The regional diversity in drug and alcohol consumption was striking, as was the absence of cocaine, methamphetamine and buprenorphine. Voluntary reporting on birth certificates and other maternal questionnaires underestimated the prevalence by 2-3 fold.

Conclusion: One in five infants born in West Virginia has a significant drug exposure that is not captured by conventional reporting instruments. It is hard to estimate the societal and financial cost since so many infants are exposed.

Summary

The prevalence of drug use in any population is essential to those planning, funding, and testing interventions to address that incidence. However, accurate ascertainment can be difficult. There is actually a paucity of reliable information in the literature on the use of illicit drugs in pregnancy, with rates reported from 10 to 14%. The prevalence appears to be increasing based on increasing numbers of infants diagnosed with neonatal abstinence syndrome (NAS); the number of cases at Cabell-Huntington Hospital tripled from 2003 to 2007. As the average cost of infants diagnosed with NAS is $36,000 as opposed to $2,000, this represents a fiscal as well as a medical and social nightmare. Just how big the problem is the question this study was designed to answer. 

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