Substance Abuse in Pregnancy: Recognizing the Problem; Seeking Solutions
Infant MortalityAlbemarle, Charlottesville and Virginia
Five-Year Rolling Averages, 1998-2008
0
2
4
6
8
10
12
14
1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 2003-2007 2004-2008
Infa
nt
Dea
ths
< O
ne
Yea
r P
er 1
000
Liv
e B
irth
s
Alb. Cville VA Healthy People 2010 Target
Source: Virginia Department of Health
Infant Mortality by RaceAlbemarle, Charlottesville and Virginia, Five-Year Rolling Averages, 1998-2008
0
5
10
15
20
25
30
1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 2003-2007 2004-2008
Infa
nt
Dea
ths
< O
ne
Yea
r P
er 1
000
Liv
e B
irth
s
Albemarle White Albemarle Black Charlottesville White Charlottesville Black
Virginia White Virginia Black Healthy People 2010 TargetSource: Virginia Department of Health
Percent of Low Weight (<2500g) Births Albemarle, Charlottesville, Virginia
Two-Year Rolling Averages,1998-2008
0
4
8
12
16
1998-99 1999-00 2000-01 2001-02 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08
Per
cen
t o
f T
ota
l Bir
ths
Albemarle Charlottesville Virginia Healthy People 2010 Target
12
Source: Virginia Department of Health
Percent of Live Births in which Maternal Substance Abuse Was Reported
Charlottesville, Albemarle, and VirginiaFour-Year Rolling Averages 2000-2008
8.4%9.2%9.8%11.2%12.2%11.9%
0%
20%
40%
60%
80%
100%
Pe
rce
nt
of
To
tal
Liv
e B
irth
s
CharlottesvilleAlbemarle
Virginia
2000- 2001-04 2003-062002- 2004-07 2005-
2005-08Charlottesville 8.4%Virginia 6.8%Albemarle 5.2%
Percent of Live Births in which Tobacco Use Was ReportedCharlottesville, Albemarle, and VirginiaFour-Year Rolling Averages 2000-2008
8.2%8.8%9.4%10.7%11.6%11.5%
0%
20%
40%
60%
80%
100%
Pe
rce
nt
of
To
tal
Liv
e B
irth
s
CharlottesvilleAlbemarle
Virginia
2000-03 2001-04 2003-062002-05 2004-07 2005-08
2005-08Charlottesville 8.2%Virginia 6.4%Albemarle 5.0%
Substances ReportedCharlottesville and Virginia, 2008
83%
1%
10%
6%
Tobacco
Alcohol
Marijuana
Cocaine
Charlottesville
86%
6%
2%
2%
4%
Tobacco
Alcohol
Marijuana
Cocaine
Virginia
Methadone & Heroine
Birth Certificate Data
• Source: Virginia Department of Health, Division of Health Statistics and Division of Vital Statistics
• Hospitals required to collect information from the mother– MJH Questions
• Asks how much alcohol do you drink each day?• How much tobacco do you use to each day? Number of years?• What recreational drugs do you use/frequency?
• Under-reported
IPO Focus Groups - 2009• Mentor mothers (4) with Resource Mothers, FOCUS
• Females (26) from Charlottesville neighborhoods with higher proportion of low birth weight or premature births
– Ages 15 – 73 years (median 26.5 years)
– Majority African-American
– Westhaven, Blue Ridge Commons, Attention Home
– 19 females were, or had ever been, pregnant
– 39% reported that they themselves or someone they knew had given birth to a baby that died before one year of age
Findings: Substance Use
• Substances, especially cigarettes and marijuana, are regularly used before and during pregnancy to cope with stress
• Consequences for the fetus are not fully appreciated
National Institute on Drug Abuse (NIDA)
• Of women who use illicit drugs, about half are of childbearing age (15 to 44 years old)
• Nationwide hospital survey to determine the extent of drug abuse among pregnant women in the United States – 1992-93
• Of 4 million women who gave birth
– 19% (757,000) drank alcohol
– 21% (820,000) smoked cigarettes
– 6% (221,000) used illegal drugs • 119,000 - marijuana • 45,000 - cocaine
• Generally, rates were higher in women: – who were not married
– had less than 16 years of formal education
– were not working
– relied on some public source of funding to pay for their hospital stay
Estimated Number by Race
• Alcohol– White - 588,000– African American - 105,000 – Hispanic - 54,000
• Tobacco– White - 632,000– African American -132,000– Hispanic - 36,000
Age Differences
• Rates of marijuana use were highest among those under 25 years old
• Rates of cocaine use were higher among those 25 years and older