Substance Abuse During Pregnancy

Preface Substance Abuse During Pregnancy

Hilary Smith Connery, MD, PhD William F. Rayburn, MD, MBA Editors

This issue of Obstetrics and Gynecology Clinics of North America deals with the timely subject of substance use during pregnancy. Alcohol, tobacco, and illicit drug use is prevalent among reproductive-age women. Even though a reduction in use often occurs during pregnancy, many women continue to use substances until a pregnancy is either actually diagnosed or well underway. Patient interviews and urine toxicologic testing at the initial prenatal visit and at delivery suggest that substance use during pregnancy ranges from 0.4% to 27%, depending on the population surveyed. Care of the pregnant woman with a substance use disorder is often complex and demanding. Providers must be aware of these women’s unique psychologic and social needs and the related legal and ethical ramifications surrounding pregnancy. In addition, effects from specific illicit drugs on eventual perinatal outcomes are difficult to predict. Concurrent use of multiple substances and co-occurring mental health problems are common. Many pregnant substance abusers are members of economically disadvantaged segments of society in which unfavorable perinatal outcomes are more common. This issue consists of a well-qualified team of obstetricians-gynecologists, psychiatrists, and family physicians, focusing on various issues related directly to pregnancies complicated by substance use. Topics of interest include epidemiology and screening for hazardous and harmful substance use, teratogenic risks, psychiatric comorbidities, comprehensive treatment approaches before and after delivery, fetal surveillance, and team-based perinatal management. Particularly new information relates to prescribing buprenorphine, neonatal abstinence syndrome, and adolescent substance use. Our intent is to activate attention to issues about substance use disorders for all providers caring for pregnant women and women of child-bearing age who may be at increased risk for unintended pregnancy due to substance use patterns. Practical information provided herein will hopefully offer strategies to optimize team-based care for this vulnerable population and their unborn infants. We are grateful to our friends Obstet Gynecol Clin N Am 41 (2014) xiii–xiv http://dx.doi.org/10.1016/j.ogc.2014.02.003 0889-8545/14/$ – see front matter Ó 2014 Published by Elsevier Inc.

obgyn.theclinics.com

xiv

Preface

and colleagues, who contributed their time and expertise to this edition. Their commitment to quality care and advancement of patient safety are exemplary. Hilary Smith Connery, MD, PhD Division of Alcohol and Drug Abuse Department of Psychiatry Harvard Medical School, McLean Hospital 115 Mill Street, Mail Stop 222 Belmont, MA 02478-1064, USA William F. Rayburn, MD, MBA Department of Obstetrics and Gynecology Continuing Medical Education and Professional Development University of New Mexico School of Medicine MSC10 5580, 1 University of New Mexico Albuquerque, NM 87131-0001, USA E-mail addresses: [email protected] (H.S. Connery) [email protected] (W.F. Rayburn)

Substance abuse during pregnancy.

Substance abuse during pregnancy. - PDF Download Free
111KB Sizes 6 Downloads 5 Views