Drug use and limited prenatal care: an examination of responsible barriers
Received 27 March 2008; received in revised form 6 July 2008; accepted 30 October 2008. published online 17 February 2009.
Objective
The purpose of this study was to determine sociodemographic, psychosocial, and health belief factors that explain the association between maternal drug use and little or no prenatal care.
Study Design
A cohort of 812 low-income women who delivered at Johns Hopkins Hospital were administered a postpartum survey. Drug use was determined by self-report, medical record, and toxicologic screens. Medical records were abstracted to determine little or no prenatal care, as defined by ≤ 1 visit.
Results
Adjustments for sociodemographic characteristics and cocaine and opiate use were predictive of little or no prenatal care. The effect of cocaine was explained by psychosocial and health belief factors: external locus of control, fear of being reported to police, and disbelief in the efficacy of care. Opiate use remained strongly related to little or no care in fully adjusted models (odds ratio, 3.16; P < .001).
Conclusion
Different outreach and education strategies may be necessary to enroll cocaine- vs opiate-using women into prenatal care.
Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Reprints: Ashley H. Schempf, PhD, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205
Cite this article as: Schempf AH, Strobino DM. Drug use and limited prenatal care: an examination of responsible barriers. Am J Obstet Gynecol 2009;200:412.e1-412.e10.
This study was supported by Grants from the National Institutes of Health: NIDA R01-DA007621 (D.M.S.) and NIDA R03-DA020632 (A.H.S.).
Authorship and contribution to the article is limited to the 2 authors indicated.
ABSTRACT
Drug use and limited prenatal care: an examination of responsible barriers