Un suivi multidisciplinaire et un soutien psychosocial diminuent les complications de la dépendance aux opiacés chez les femmes enceintes114 grossesses suivies en 5 ans

Purpose, Drug abuse during pregnancy is on important public health problem. Montpellier University Hospital established a center for addiction and pregnancy in 1997 to provide multidisciplinary prenatal core aimed at reducing maternal Gad fetal risks during pregnancy and afterwards. This study assesses the trends in drug-taking behavior and pregnancy outcome among women receiving this prenatal core. Methods > This exploratory prospective study examined participants in this program during its first 5 years (1997-2002). Women were included if they had been: pregnant, addicted to opiates, enrolled in the program for at least 15 days, and if their delivery took place at Montpellier Hospital. We recorded how often they come to prenatal core, drug-taking behavior social and economic level, and obstetrical and neonatal outcomes. Results > The study included 114 women. Those receiving drug substitution at the onset of pregnancy mainly sow general practitioners (64189 at the beginning of pregnancy), who most often prescribed buprenorphine (701105 at the end of pregnancy). more than two thirds of patients (n=78) abused several substances. Heroine abuse decreased (p < 0.01) over pregnancy and social and economic level rose (p < 0. 00 1). Mean gestational age at delivery was 38.5 weeks. Neonatal withdrawal syndrome remained an important problem and required treatment in 89 infants (78%). No mothers abandoned their infant. Conclusion > Multidisciplinary prenatal core with medical, social, and psychological support can decrease opiate abusers' risks during pregnancy even when the drug treatment program is essentially unsupervised.