West Virginia Study to Help Identify Pregnancy Risks from Substance Abuse
Health care professionals in West Virginia are planning to conduct studies to learn more about the risks of substance abuse during pregnancy. They hope their findings will help provide earlier and better care for mothers and newborns.
The West Virginia Perinatal Partnership plans to study umbilical cord tissue of babies born in the state and create a uniform maternal health screening of expectant women. The partnership includes hospitals, health care organizations, medical schools, state agencies, and churches.
Members of the partnership and state lawmakers have begun working on developing universal maternal screening methods to better identify high-risk pregnancies from drug, tobacco, or alcohol use; hypertension; diabetes; and other factors that can negatively affect the fetus.
"When we get the information after the baby is born, it's too late," said Dr. Stefan Maxwell, chief of pediatrics at Charleston Area Medical Center and chairman of the partnership's Committee on Drug Use During Pregnancy. "The effects are long lasting."
Confidentiality will be part of the screening process so that pregnant women can feel comfortably admitting substance abuse. “If you’re using cocaine or heroin you don’t particularly want to tell anyone about it because it’s illegal,” Maxwell said.
Partnership project director Nancy Tolliver said that there should be some kind of protection from legal prosecution so pregnant women can come forward early and get treatment. "As long as she comes in early, tells the doctor, the midwife, that she's using some drugs then she's protected," Tolliver said. "This does not protect her after the birth, only during the pregnancy when she's getting treatment."
Tolliver said that early intervention is key because critical development takes place during the first few months of pregnancy. "If a woman becomes pregnant she has a very strong desire to be off the drugs because she knows it's harmful," Tolliver said. "That is one the best times to try and help."
The partnership is also working on guidelines for medical practitioners to address substance abuse during pregnancy. Members also want to learn more about the prevalence of substance abuse among pregnant women so they can develop educational programs for mothers.
"We think that the most effective way of determining the prevalence of drug use among pregnant women in West Virginia is to conduct a cord tissue study so samples of the umbilical cord can be sent away to a laboratory and tested for drugs that have been used by the mother," Tolliver said.
"Many of those babies have to be detoxed after birth, which means they are suffering from withdrawal," Tolliver said. "They have feeding problems, they have breathing problems and problems bonding with the parent because their brain that helps them bond and form relationships is not functioning properly."
Premature delivery is another risk of substance abuse during pregnancy, as well as learning and attention disabilities in childhood. A study published earlier this year showed that in 2005, 34 of 2,549 babies born at Cabell Huntington Hospital were diagnosed with neonatal abstinence syndrome. Another 14 babies were transferred to the hospital, making the total 48 babies. The study was conducted after hospital staff reported more addicted mothers and babies with drug withdrawal.
A 2006 West Virginia Health Care Authority review showed increased rates of newborns treated for drug withdrawal at hospitals in the state. A 2007 survey of obstetrical nurse managers in the state showed the 85 percent felt the most common drug found in newborns was marijuana. In addition, a 2007-2008 study showed that in about 5 percent of 17,349 deliveries over a year, mothers indicated they had used drugs, alcohol, or other substances during pregnancy.
Tolliver says the partnership needs to do the cord tissue study to find out what drugs or alcohol pregnant mothers are using “so we can gear prevention activities in that direction.” Cord tissue testing has a universally available source and can detect drugs from over a much longer period of time than a normal drug test.
The partnership hopes to conduct a pilot study in the next year at about 10 different hospitals in West Virginia. The samples would be taken anonymously. Dr. Maxwell hopes that drawing more attention to the issue can help bring in more funding for resources and rehabilitation programs. In addition, they hope to be able to protect children from drug abuse after they are born.
