Pregnancy And Drug Dependence Opioids And Cocaine During

the 1980s, increasing numbers of pregnant drug-dependent women went to medical facilities—some to receive ongoing prenatal care, but others only to deliver their babies without the benefit of any prenatal care. Such women fear the threat of confrontation with legal authorities. The general lack of women-oriented drug-treatment programs contributes to this major health problem—addiction in pregnancy. It has also contributed to increased medical and social maladies and mortality in such mothers and their infants.

The 1990 NATIONAL HOUSEHOLD SURVEY ON DRUG Abuse estimated that almost 50 percent, approximately 29 million of the 60 million women of child-bearing age, used an illicit drug at least once in their lifetimes. In 1988, one study reported for the United States an annual occurrence rate (prevalence) of 11 percent, resulting in an estimated 375,000 drug-exposed births; these data cannot be applied to the entire country, since they were collected from a limited number of mainly urban hospitals—and the frequency, amount, type, and duration of drugs used were unavailable. The basis is also unclear for the reported estimates of 50,000 to 100,000 cocaine-exposed babies born each year. The occurrence of drug abuse among pregnant women varies widely in local studies—from 7.5 percent in Rhode Island, to 14.8 percent in Pinellas

County, Florida, to 17 to 31 percent in a Boston hospital. These local rates cannot be used to estimate the prevalence of drug abuse among pregnant women in the United States; they can only provide data for averages.

As a result of the uncertainty among data sources, in 1992, the NATIONAL INSTITUTE ON DRUG ABUSE (NIDA) began a national hospital-based study known as the National Pregnancy and Health Survey. This survey collected data on the prevalence of licit and illicit drug use by pregnant women, limited data on infant birth weight, and the duration of hospital stay. The results were released in late 1994 and the summary tables are included here. Additional surveys in progress include the National Maternal and Health Survey conducted by the National Center for Health Statistics, which will collect data on drug-abusing women who had a live birth, stillbirth, or an infant who died before one year of age, and the National Longitudinal Survey, which collects data on the frequency of marijuana and cocaine use during pregnancy by women who have given birth to a child since 1986.

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