Abstract

Drug and alcohol misuse during pregnancy is often associated with adverse fetal and maternal outcomes, due to the direct effect of the substances on woman and fetus and the generally chaotic lifestyles commonly observed among individuals that abuse drugs. We undertook an audit of mothers who abused alcohol and drugs in Pennine Acute NHS Trust, focusing on the outcomes during the antenatal period, labour, and the postnatal period, as well as the engagement of the mother with antenatal services.

Converse to our expectations, the outcomes for substance-abusing women in the Trust were not overly poor. 71% of pregnancies encountered no fetal problems, with 21% suspected IUGR and 8% other problems, including polyhydramnios, oligohydramnios and reduced fetal movement. 81% of women experienced no problems during delivery; maternal pyrexia (4%), uterine rupture (0.6%), pre-eclampsia (0.6%) and hypertension (0.6%) were among the difficulties encountered. All 155 women had live-births, with 11 neonates requiring admission to the Special Care Baby Unit. 90% of the babies were discharged home with the mother, with 8% going into foster care and the remainder going to another family member’s home.

We believe that these positive outcomes could be related to the engagement with antenatal services noted, as the average number of antenatal contacts was 9 visits. This suggests that a dedicated drug and alcohol misuse team are vital in ensuring that substance misusers are engaging with antenatal services, and receiving the care necessary to maximise the chances of a normal pregnancy and the delivery of a healthy baby.