A ‘one-stop’ clinic for drug using pregnant women

Abstract

This study reviews the impact of a multidisciplinary team approach on maternal and fetal outcomes in women who substance-abuse during pregnancy. The multidisciplinary team includes obstetrician, senior midwife, prescribing/addiction unit doctor, health visitor and ultrasonographer. Women were seen in a hospital environment and attended every 2 weeks, or more if required. This was a retrospective study of 218 patients attending the specialised ‘one-stop’ clinics in three large hospitals from January 1999 to December 2001. Overall, the mean gestation at booking was 17.2 weeks with a decreasing trend from over 18 weeks to 16 weeks over the 3 years. The mean gestation at delivery was 38.1 weeks with a mean birth weight of 2.9 kg, demonstrating a good outcome in the majority of women. At the beginning of pregnancy, 60% of the women used heroin regularly. At discharge 6 weeks postnatally only 28% were still substance-using. Of the remaining women, 50% were on a substitution programme of either methadone or dihydrocodeine. Around 25% of the babies required treatment for neonatal abstinence syndrome. Most of the babies went home with their mother.