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Neonatal illicit drug screening practices in Iowa: the impact of utilization of a structured screening protocol

Journal of Perinatology volume 26, pages 660–666 (2006)Cite this article

Abstract

Objective:

The purpose of the study was to determine the neonatal illicit drug screening practices of Iowa birthing hospitals.

Study design:

Cross-sectional survey design was implemented. The impact of structured screening protocols on the numbers of neonates screened and positive testing in 2004 was reviewed.

Results:

Of 81 birthing hospitals, 53 (65%) participated in the study. Screening and positive test rates were higher in hospitals utilizing a structured screening protocol compared to those not utilizing one (10.9 versus 2.1% and 0.9 versus 0.2%, respectively, P<0.0001). Hospitals with higher population, numbers of outpatients, inpatients, deliveries, and availability of drug abuse treatment services utilized a structured screening protocol more often.

Conclusion:

Utilization of a structured screening protocol increases the number of neonates screened for illicit drugs and positive testing rate regardless of urbanization. Regional standardization of structured screening protocols may improve the recognition of perinatal illicit drug exposure and provision of treatment services.

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References

  1. Bar-Oz B, Klein J, Karaskov T, Koren G . Comparison of meconium and neonatal hair analysis for detection of gestational exposure to drugs of abuse. Arch Dis Child Fetal Neonatal Ed 2003; 88: 98–100.

    Article  Google Scholar 

  2. Hohman MM, Shillington AM, Baxter HG . A comparison of pregnant women presenting for alcohol and other drug treatment by CPS status. Child Abuse Negl 2003; 27 (2): 303–318.

    Article  PubMed  Google Scholar 

  3. Ostrea EM, Brady M, Gause S, Raymundo AL, Stevens M . Drug screening of newborns by meconium analysis: a large-scale, prospective, epidemiologic study. Pediatrics 1992; 89 (1): 107–113.

    PubMed  Google Scholar 

  4. Eyler FD, Behnke M, Conlon M, Woods NS, Wobie K . Birth outcome from a prospective, matched study of prenatal crack/cocaine use: II. Interactive and dose effects on neurobehavioral assessment. Pediatrics 1998; 101 (2): 237–241.

    Article  CAS  Google Scholar 

  5. Frohna JG, Lantz PM, Pollack H . Maternal substance abuse and infant health: policy options across the life course. Millbank Q 1999; 77 (4): 531–570.

    Article  CAS  Google Scholar 

  6. Chasnoff IJ . Cocaine, pregnancy, and the growing child. Curr Probl Pediatr Adolesc Health Care 1992; 22 (7): 302–321.

    Article  CAS  Google Scholar 

  7. Griffith DR . Prenatal exposure to cocaine and other drugs: developmental and educational prognoses. Phi Delta Kappan 1992; 9: 30–34.

    Google Scholar 

  8. Albert V, Klein D, Noble A, Zahand E, Holtby S . Identifying substance abusing delivering women: consequences for child maltreatment reports. Child Abuse Negl 2000; 24 (2): 173–183.

    Article  CAS  PubMed  Google Scholar 

  9. Zellman GL, Fair CC, Hoube J, Wong M . A search for guidance: examining prenatal substance exposure protocols. Matern Child Health J 2002; 6 (3): 205–212.

    Article  PubMed  Google Scholar 

  10. Arizona State Department of Public Health Practice Improvement Protocol 5. Substance use, abuse and/or dependence in pregnant and postpartum women. http://www.azdhs.gov/bhs/guidance/substance.pdf.

  11. Washington State Department of Public Health Guidelines for screening substance abuse during pregnancy. http://www.doh.wa.gov/Publicat/Screening_Guidelines.pdf.

  12. Indiana State Department of Public Health Newborn Meconium Screening Program. http://www.in.gov/isdh/programs/nbs/MecScrCriteria.htm.

  13. Iowa Hospital Association. http://www.ihaonline.org/publications/profileserv/profileserv.shtml.

  14. Ostrea EM, Knapp DK, Tannenbaum L, Ostrea AR, Romero A, Salari V et al. Estimates of illicit drug use during pregnancy by maternal interview, hair analysis, and meconium analysis. J Pediatr 2001; 138 (3): 344–348.

    Article  CAS  PubMed  Google Scholar 

  15. Appel PW, Hoffman JH, Blane HT, Frank B, Oldak R, Burke M . Comparison of self-report and hair analysis in detecting cocaine use in a homeless/transient sample. J Psychoactive Drugs 2001; 33 (1): 47–55.

    Article  CAS  PubMed  Google Scholar 

  16. Bibb KW, Stewart DL, Walker JR, Cook VD, Wagener RE . Drug screening in newborns and mothers using meconium samples, paired urine samples, and interviews. J Perinatol 1995; 15 (3): 199–202.

    CAS  PubMed  Google Scholar 

  17. Sweeney PJ, Schwartz RM, Mattis NG, Vohr B . The effect of integrating substance abuse treatment with prenatal care on birth outcome. J Perinatol 2000; 4: 219–224.

    Article  Google Scholar 

  18. Brown JV, Bakeman R, Coles CD, Platzman KA, Lynch ME . Prenatal cocaine exposure: a comparison of two year-old children in parental and nonparental care. Child Dev 2004; 75 (4): 1282–1295.

    Article  PubMed  Google Scholar 

  19. Berger L, Waldfogel J . Prenatal cocaine exposure: long-rung effects and policy implications. Soc Serv Rev 2000; 74 (1): 28–54.

    Article  Google Scholar 

  20. El-Mohandes A, Herman AA, Nabil El-Khorazaty M, Katta PS, White D, Grylack L . Prenatal care reduces the impact of illicit drug use on perinatal outcomes. J Perinatol 2003; 23 (5): 354–360.

    Article  PubMed  Google Scholar 

  21. Little BB, Snell LM, Van Beveren TT, Crowell RB, Trayler S, Johnston WL . Treatment of substance abuse during pregnancy and infant outcome. Am J Perinatol 2003; 20 (5): 255–262.

    Article  PubMed  Google Scholar 

  22. Zellman GL, Bell RM, Archie C, DuPlessis H, Hoube J, Miu A . Physician response to prenatal substance exposure. Matern Child Health J 1999; 3 (1): 29–38.

    Article  CAS  PubMed  Google Scholar 

  23. Jaudes PK, Ekwo E, Van Voorhis J . Association of drug abuse and child abuse. Child Abuse Negl 1995; 19 (9): 1065–1075.

    Article  CAS  PubMed  Google Scholar 

  24. Easton S, Oral R . Factors associated with parental drug involvement in confirmed cases of child maltreatment. Proceedings of 19th San Diego Conference on Child maltreatment, San Diego, California, January 24–28 2005.

  25. Locke TF, Newcomb M . Child maltreatment, parent alcohol and drug-related problems, polydrug problems, and parenting practices: a test of gender differences and four theoretical perspectives. J Fam Psychol 2004; 18 (1): 120–134.

    Article  PubMed  Google Scholar 

  26. Stein JA, Leslie MB, Nyamathi A . Relative contributions of parent substance use and childhood maltreatment to homelessness, depression, and substance abuse problems among homeless women: mediating roles of self-esteem and abuse in adulthood. Child Abuse Negl 2002; 26 (10): 1011–1027.

    Article  PubMed  Google Scholar 

  27. Walsh C, MacMillan HL, Jamieson E . The relationship between parental substance abuse and child maltreatment: findings from the Ontario Health Supplement. Child Abuse Negl 2003; 27 (12): 1409–1425.

    Article  PubMed  Google Scholar 

  28. Nair P, Schuler ME, Black MM, Kettinger L, Harrington D . Cumulative environmental risk in substance abusing women: early intervention, parenting stress, child abuse potential and child development. Child Abuse Negl 2003; 27 (9): 997–1017.

    Article  PubMed  Google Scholar 

  29. Azuma SD, Chasnoff IJ . Outcome of children prenatally exposed to cocaine and other drugs: a path analysis of three-year data. Pediatrics 1993; 92 (3): 396–402.

    CAS  PubMed  Google Scholar 

  30. Chasnoff IJ, Anson A, Hatcher R, Stenson H, Iaukea K, Randolph LA . Prenatal exposure to cocaine and other drugs: outcome at four to six years. Ann NY Acad Sci 1998; 846: 314–328.

    Article  CAS  Google Scholar 

  31. Van Dyke DC, Fox AA . Fetal drug exposure and its possible implications for learning in the preschool and school-age population. J Learn Disabil 1990; 23 (3): 160–163.

    Article  CAS  PubMed  Google Scholar 

  32. Tyler R, Howard J, Espinosa M, Doakes SS . Placement with substance-abusing mothers vs placement with other relatives: infant outcomes. Child Abuse Negl 1997; 21 (4): 337–349.

    Article  CAS  PubMed  Google Scholar 

  33. Oral R, Mueller R, Ahmed W . Prevalence of known risk factors for in-utero illicit drug exposure in mother–infant dyads admitted to UIHC for delivery in 2002–2003. Postgraduate Conference Proceedings, 23–24 September 2005, Iowa City, Iowa.

  34. Kwong TC, Ryan RM . Detection of intrauterine illicit drug exposure by newborn testing. Clin Chem 1997; 43 (1): 235–242.

    CAS  PubMed  Google Scholar 

  35. O’Connor TA, Bondurant HH, Siddiqui J . Targeted perinatal drug screening in a rural population. J Matern Fetal Neonatal Med 1997; 6 (2): 108–110.

    Google Scholar 

  36. Chasnoff IJ, Landress HJ, Barrett ME . Prevalence of illicit drug or alcohol use during pregnancy and discrepancies in mandatory reporting in Pinellas County, Florida. N Engl J Med 1990; 322 (17): 1202–1206.

    Article  CAS  Google Scholar 

  37. Birchfield M, Scully J, Handler A . Perinatal screening for illicit drugs: policies in hospitals in a large metropolitan area. J Perinatol 1995; 15: 208–214.

    CAS  PubMed  Google Scholar 

  38. Zellman GL, Jacobson PD, Bell RM . Influencing physician response to prenatal substance exposure through state legislation and work place policies. Addiction 1997; 92 (9): 1123–1131.

    Article  CAS  PubMed  Google Scholar 

  39. Ondersma SJ, Simpson SM, Brestan EV, Ward M . Prenatal drug exposure and social policy: the search for an appropriate response. Child Maltreat 2000; 5 (2): 93–108.

    Article  CAS  PubMed  Google Scholar 

  40. Adirim TA, Sen Gupta N . A national survey of state maternal and newborn drug testing and reporting policies. Public Health Rep 1991; 106 (3): 292–296.

    CAS  PubMed  PubMed Central  Google Scholar 

  41. Annas GJ . Testing poor pregnant patients for cocaine – physicians as police investigators. N Engl J Med 2001; 344 (22): 1729–1732.

    Article  CAS  PubMed  Google Scholar 

  42. Ondersma SJ, Malcoe LH, Simpson SM . Child protective services' response to prenatal drug exposure: results from a nationwide survey. Child Abuse Negl 2001; 25 (5): 657–668.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

This study was made possible by a grant from Children's Miracle Network. The preliminary results were presented at the Fall Conference of Children's Hospital of Iowa 9/22-23/2005, Iowa City, IA.

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Authors and Affiliations

  1. Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA, USA

    R Oral

  2. School of Social Work, University of Iowa, Iowa City, IA, USA

    T Strang

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  1. R Oral
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Correspondence to R Oral.

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Oral, R., Strang, T. Neonatal illicit drug screening practices in Iowa: the impact of utilization of a structured screening protocol. J Perinatol 26, 660–666 (2006). https://doi.org/10.1038/sj.jp.7211601

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