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Open Access Highly Accessed Research article

Substance abuse in pregnant women. Experiences from a special child welfare clinic in Norway

Bjørg Hjerkinn1*, Morten Lindbæk2 and Elin Olaug Rosvold2

Author Affiliations

1 Addiction Unit/Research Unit, Sørlandet Hospital, Kristiansand, Norway

2 Institute of General Practice and Community Medicine, Faculty of Medicine, University of Oslo, Norway

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BMC Public Health 2007, 7:322  doi:10.1186/1471-2458-7-322

Published: 11 November 2007

Abstract

Background

Substance abuse during pregnancy may harm the foetus and can cause neonatal abstinence syndrome. Exposure to alcohol and other substances can influence the child for the rest of its life. A special child welfare clinic was set up in 1994 in Kristiansand, Norway, targeting pregnant women with substance abuse problems in the county of Vest-Agder. Pregnancy is not an indication for opioid replacement therapy in Norway, and one of the clinic's aims was to support the drug dependent women through their pregnancy without any replacements. The object of this paper is to describe concurrent health and social problems, as well as the predictors for stopping drug abuse, in the clinic's user group.

Methods

Retrospective cohort study. Data was gathered from the medical records of all 102 women seen in the clinic in the period between 1992 and 2002. The study includes 59 out of 60 women that were followed until their children were two years old or placed in alternative care, and a comparison group of twice the size. Both groups were presented with a questionnaire concerning both the pregnancy and health and socio-economic issues.

Results

Four (4.5 percent) of the women that completed their pregnancies did not manage to reduce their substance abuse. All the others reduced their substance abuse considerably. The odds ratio for stopping substance abuse within the first trimester was significantly associated with stopping smoking (O.R. 9.7) or being victims of rape (O.R. 5.3).

Conclusion

A low cost and low threshold initiative organised as a child welfare clinic may support women with substance abuse problems in their efforts to stop or reduce their substance abuse during pregnancy.