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Trends in Drug-exposed Deliveries From 2002 to 2009

Martin, Caitlin E. MPH*; Mak, Candice MD; Miller, Catherine MSW; Welsh, Chris MD§; Terplan, Mishka MD, MPH

Addictive Disorders & Their Treatment:
doi: 10.1097/ADT.0000000000000044
Original Articles
Abstract

Objectives: The objective of this study was to describe the changing prevalence of and factors associated with illicit drug exposure assessed by universal urine toxicology at the time of delivery.

Methods: All live births at a single tertiary care center from 2002 to 2009 were identified. Rates of drug exposure were calculated overall, by year and compared across time. ANOVA and logistic regression were used to assess differences in proportions and associations of drug-exposed deliveries over time.

Results: A total of 13,531 live births were identified, of which 8% (N=1080) were exposed to marijuana, opiates, cocaine, or benzodiazepines. This percentage changed throughout the study period from 8.0% in 2002 to 5.4% in 2009 (P<0.01). Cocaine and opiate exposures both peaked in 2005 (cocaine 3.0%; opiates 4.4%) then decreased to their nadirs in 2009 (cocaine 0.7%, P<0.01; opiates 2.6%, P=0.09). Benzodiazepine exposure gradually increased from 2002 (0.3%) to 2009 (1.0%; P=0.01), whereas there was no clear trend in marijuana exposure (P=0.08). Methadone exposure peaked in 2006 (2.3%) and decreased to its nadir in 2009 (0.8%; P=0.03). Women with a drug-exposed delivery were more likely to be older (AOR, 1.71; 95% CI, 1.32-2.22), employed (unemployed AOR, 0.51; 95% CI, 0.43-0.61), white (black AOR, 0.69; 95% CI, 0.55-0.87), and have public insurance (AOR, 2.53; 95% CI, 1.97-3.26).

Conclusions: Although drug-exposed deliveries have decreased, they are still common. Knowledge of drug trends is essential to guide local perinatal health policy.

Author Information

*Johns Hopkins School of Medicine

Department of Obstetrics and Gynecology, St Agnes Hospital

Department of Social Work, University of Maryland Medical Center

Departments of §Psychiatry

Obstetrics, Gynecology, and Reproductive Sciences & Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD

Poster presented at The 59th Annual Clinical Meeting of The American Congress of Obstetricians and Gynecologists (ACOG), May 2011, Washington, DC.

The authors declare no conflict of interest.

Reprints: Mishka Terplan, MD, MPH, Departments of Obstetrics, Gynecology, and Reproductive Sciences & Epidemiology and Public Health, University of Maryland School of Medicine, 11 S Paca Street, Suite 400, Baltimore, MD 21201 (e-mail: mterplan@fpi.umaryland.edu).

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