Substance Abuse in Pregnancy: Recognizing the Problem; Seeking Solutions

Infant MortalityAlbemarle, Charlottesville and Virginia

Five-Year Rolling Averages, 1998-2008

0

2

4

6

8

10

12

14

1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 2003-2007 2004-2008

Infa

nt

Dea

ths

< O

ne

Yea

r P

er 1

000

Liv

e B

irth

s

Alb. Cville VA Healthy People 2010 Target

Source: Virginia Department of Health

Infant Mortality by RaceAlbemarle, Charlottesville and Virginia, Five-Year Rolling Averages, 1998-2008

0

5

10

15

20

25

30

1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 2003-2007 2004-2008

Infa

nt

Dea

ths

< O

ne

Yea

r P

er 1

000

Liv

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Albemarle White Albemarle Black Charlottesville White Charlottesville Black

Virginia White Virginia Black Healthy People 2010 TargetSource: Virginia Department of Health

Percent of Low Weight (<2500g) Births Albemarle, Charlottesville, Virginia

Two-Year Rolling Averages,1998-2008

0

4

8

12

16

1998-99 1999-00 2000-01 2001-02 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08

Per

cen

t o

f T

ota

l Bir

ths

Albemarle Charlottesville Virginia Healthy People 2010 Target

12

Source: Virginia Department of Health

Percent of Live Births in which Maternal Substance Abuse Was Reported

Charlottesville, Albemarle, and VirginiaFour-Year Rolling Averages 2000-2008

8.4%9.2%9.8%11.2%12.2%11.9%

0%

20%

40%

60%

80%

100%

Pe

rce

nt

of

To

tal

Liv

e B

irth

s

CharlottesvilleAlbemarle

Virginia

2000- 2001-04 2003-062002- 2004-07 2005-

2005-08Charlottesville 8.4%Virginia 6.8%Albemarle 5.2%

Percent of Live Births in which Tobacco Use Was ReportedCharlottesville, Albemarle, and VirginiaFour-Year Rolling Averages 2000-2008

8.2%8.8%9.4%10.7%11.6%11.5%

0%

20%

40%

60%

80%

100%

Pe

rce

nt

of

To

tal

Liv

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irth

s

CharlottesvilleAlbemarle

Virginia

2000-03 2001-04 2003-062002-05 2004-07 2005-08

2005-08Charlottesville 8.2%Virginia 6.4%Albemarle 5.0%

Substances ReportedCharlottesville and Virginia, 2008

83%

1%

10%

6%

Tobacco

Alcohol

Marijuana

Cocaine

Charlottesville

86%

6%

2%

2%

4%

Tobacco

Alcohol

Marijuana

Cocaine

Virginia

Methadone & Heroine

Birth Certificate Data

• Source: Virginia Department of Health, Division of Health Statistics and Division of Vital Statistics

• Hospitals required to collect information from the mother– MJH Questions

• Asks how much alcohol do you drink each day?• How much tobacco do you use to each day? Number of years?• What recreational drugs do you use/frequency?

• Under-reported

IPO Focus Groups - 2009• Mentor mothers (4) with Resource Mothers, FOCUS

• Females (26) from Charlottesville neighborhoods with higher proportion of low birth weight or premature births

– Ages 15 – 73 years (median 26.5 years)

– Majority African-American

– Westhaven, Blue Ridge Commons, Attention Home

– 19 females were, or had ever been, pregnant

– 39% reported that they themselves or someone they knew had given birth to a baby that died before one year of age

Findings: Substance Use

• Substances, especially cigarettes and marijuana, are regularly used before and during pregnancy to cope with stress

• Consequences for the fetus are not fully appreciated

National Institute on Drug Abuse (NIDA)

• Of women who use illicit drugs, about half are of childbearing age (15 to 44 years old)

• Nationwide hospital survey to determine the extent of drug abuse among pregnant women in the United States – 1992-93

• Of 4 million women who gave birth

– 19% (757,000) drank alcohol

– 21% (820,000) smoked cigarettes

– 6% (221,000) used illegal drugs • 119,000 - marijuana • 45,000 - cocaine

• Generally, rates were higher in women: – who were not married

– had less than 16 years of formal education

– were not working

– relied on some public source of funding to pay for their hospital stay

Estimated Number by Race

• Alcohol– White - 588,000– African American - 105,000 – Hispanic - 54,000

• Tobacco– White - 632,000– African American -132,000– Hispanic - 36,000

Age Differences

• Rates of marijuana use were highest among those under 25 years old

• Rates of cocaine use were higher among those 25 years and older