Sunday, 16 January 2005 - 8:45 AM

This presentation is part of: Substance Abuse in Women

The Effect of Service Duration and Intensity on Birth Outcomes of Infants Born to Mothers Participating in Substance Abuse Treatment

Purpose: The potential for poor birth outcomes, especially low birth weight and prematurity, increases with drug use during pregnancy. Comprehensive services for substance abusing, pregnant women integrate prenatal care with substance abuse treatment services to increase the likelihood of positive birth outcomes for infants born to women in treatment. However, limited research examining the relationship of these services to birth outcomes exists. In an effort to address this knowledge gap, this study investigated the relationships of birth outcomes to women's use of comprehensive prenatal and substance abuse services in a program serving low-income rural women.

Methods: This study analyzed program data from a community-based substance abuse program serving eight rural counties. The sample consisted of program participants who gave birth from 1997 to 2003 (N=241). Program participants were all over 18 years of age (mean=28.0); 43.6% were African American and 52.3% were white. Using race and adequacy of prenatal care as covariates, a two-way MANCOVA was conducted to determine if there were statistically meaningful differences in birth outcomes by when the pregnant woman entered the program (first trimester vs. second/third trimester) and by service intensity (high vs. low). Using a Bonferroni correction, a series of post-hoc tests were then conducted to identify on which birth outcomes the groups differed. Multiple regression was conducted to find the effect of service duration and service intensity on birth weight and gestational age.

Results: A two-way MANCOVA showed that there were significant main effects for trimester at program entry (F=4.26, p<.05) and service intensity (F=3.17, p<.05) on birth outcomes. The group that entered during the first trimester and the high service intensity group had significantly higher birth weights than their counterparts (F=6.06, p<.05; F=5.75, p<.05 respectively). However, statistically significant differences in gestational age were not found. Multiple regression found that more time in substance abuse treatment during the pregnancy and more hours of services received were associated with higher birth weights (t=2.95, p<.01 and t=2.01, p<.05 respectively).

Implications for Practice: Prematurity and low birth weight, although preventable, are outcomes with many negative life-long consequences, including health and developmental problems. In order to guide effective, integrated prenatal and substance abuse services for pregnant women, it is critical to understand the relationships among length of service and intensity of service with birth outcomes. These results show that time in treatment and intensity of treatment are related to birth outcomes of infants born to pregnant women participating in substance abuse treatment. Practice implications for developing and implementing integrated prenatal and substance abuse services will be discussed, including implications for recruiting rural women into these services early in their pregnancy and encouraging a high level of participation in these services.

See more of Substance Abuse in Women
See more of Oral and Poster

See more of Celebrating a Decade of SSWR (January 13 - 16, 2005)