Substance use in rural Midwestern pregnant women
B. P. Yawn, R. A. Yawn and D. L. Uden
Department of Family Medicine and Community Health, University of Minnesota.
OBJECTIVE: To determine the rate of prenatal use of cocaine, cannabis,
amphetamines, opiates, and cigarettes in rural midwestern women by analysis
of reported use of cigarettes, maternal urine drug screening at admission
to labor and delivery, and newborn meconium screening. DESIGN: The cohort
of all women presenting to labor and delivery and their newborns were
screened by urine and meconium analysis. Demographic information was also
collected and matched to the urine and meconium samples. SETTING: Four
primary care hospitals in rural Minnesota. Hospitals range in size from 66
to 140 beds, with 400 to 780 deliveries each year. PARTICIPANTS: All women
presenting to labor and delivery for evaluation of term or preterm labor
between April 4, 1991, and October 4, 1991. MEASUREMENTS/MAIN RESULTS:
Overall, drugs not administered during labor were found in a mean (+/- SD)
of 3.2% +/- 1.1% of all urine screens. Cannabis was found in 1.2% +/- 0.7%
of maternal urine samples, amphetamines in 0.8% +/- 0.58%, opiates in 1.2%
+/- 0.7%, and cocaine in 0% +/- 0.3%. Meconium samples were positive in
1.8% +/- 0.9% of cases. Cannabis was found in 1.1% +/- 0.7% of meconium
samples, opiates in 0.6% +/- 0.5%, and cocaine in 0.1% +/- 0.1%. No urine
samples were positive for more than one drug. One meconium sample tested
positive for both cocaine and cannabis. Nearly 4% of patients had either a
positive urine specimen or a positive meconium specimen. By history, 24.5%
of women admitted to smoking during pregnancy. CONCLUSION: The use of
cocaine, cannabis, opiates, and amphetamines was uncommon in this rural
population. However, one quarter of the women admitted to smoking during
pregnancy, exposing their fetuses to a dangerous substance.
