SUBSTANCE ABUSE IS A SIGNIFICANT MARKER FOR PERINATAL MORBIDITY IN A POPULATION OF WOMEN WITH POOR PRENATAL CARE IN WASHINGTON † 1560

Poor prenatal care (PNC) is an important risk factor for perinatal morbidity. This study defines the additive risk of substance abuse (SA) during pregnancy in a population of 480 D.C. residents with no/poor PNC. Poor PNC was identified if care was initiated after 24 weeks, or less than 5 visits. 35% of these post partum women showed evidence of substance abuse during pregnancy by history and/or urine testing. The two groups are compared below (results expressed as mean ±S.E.M.) The relative risk (RR) for prematurity in women with SA and no/poor PNC was 2.7, (95% C.I. = 1.6-3.8, p<0.0001). The attributable risk fraction (ARF) for LBW associated with SA in this population was 31%. The RR for LBW in women with SA and no/poor PNC was 2.6 (95% C.I. = 1.5-3.63, p<0.0001). The ARF for prematurity associated with SA in this population was 32%. We conclude that women with no/poor PNC who abuse substances during pregnancy are at exquisitely high risk for poor outcomes and deserve to be targeted specifically in programs designed to reduce perinatal/neonatal morbidity and mortality. Table

Table 1

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