The use of illicit drugs during pregnancy among mothers of premature infants.

Background: Tobacco, alcohol and/or illicit drug use during pregnancy are risk factors for neonatal complications. In Puerto Rico, the Department of Health reports that 32% of pregnant women use alcohol and 3% use illicit drugs. Nineteen percent (19.1%) of newborns are born prematurely. The purpose of this study is to determine the prevalence of illicit drug use during pregnancy in mothers of premature infants.

Methods: This study included the data of 218 mothers of premature infants admitted to the Neonatal Intensive Care Unit of the University Pediatric Hospital during 2002 to 2005 enrolled in an educational program.

Results: Fourteen women (6%) reported using illicit drugs during pregnancy (cocaine 2%, marihuana 3%, heroin 2%, methadone 2%, and ecstasy 1%). Mothers using drugs during pregnancy were more likely to start prenatal care after the first trimester (21% vs. 10% in nonusers; p < 0.01) and to smoke cigarettes (36% vs. 8% in nonusers; p < 0.01).

Conclusions: The most important maternal-prenatal risk factor for drug use in this group of mothers, was failure to receive prenatal care during the first trimester, and cigarette use. The use of illicit drugs during pregnancy complicated by a premature delivery is underestimated and many times unknown to physicians. The physicians should be assertive in gathering this information while interviewing women during pregnancy and in the postpartum period since women who use drugs during pregnancy are at higher risk of social problems, future preterm deliveries and may impair adequate follow up of their premature babies.