Authors (including presenting author) :
Siu YLC(2), Chan LSL(1), Koo MW(1), Yau YY(1), Yu KL(1), Leung CYJ(2), Ip HYK(2), Ng SM(3), Lam YY(3), Lui MY(3), Yip MY(4), Yip SY(4) Fong YL(4), Ng CW(5), Law HL(5), Wong SK(5), Ho MY(5), Yeung LM(6), Ho LF(6), Chow SY(6), Lai S(7), Lok YY(7), Leung SK(8), Ip LS(8)
Affiliation :
(1) Department of Obstetrics & Gynaecology, Kwong Wah Hospital, (2) Department of Obstetrics & Gynaecology, Princess Margaret Hospital, (3) Department of Obstetrics & Gynaecology, Prince of Wales Hospital, (4) Department of Obstetrics & Gynaecology, Pamela Youde Nethersole Eastern Hospital, (5) Department of Obstetrics & Gynaecology, Queen Elizabeth Hospital, (6) Department of Obstetrics & Gynaecology, Queen Mary Hospital, (7) Department of Obstetrics & Gynaecology, Tuen Mun Hospital, (8) Department of Obstetrics & Gynaecology, United Christian Hospital
Introduction :
Substance use in pregnancy impacts both maternal health and child health. The government funded CCDS program aims to improve the health outcomes and neonatal outcomes of high-risk pregnant women and to provide comprehensive services to high-risk children. The role of midwives in the program ranges from prenatal to postnatal. This is the first territory-wide study to collect data of pregnant women with substance abuse who were under the care of HA birthing hospitals in Hong Kong.
Objectives :
(1) To identify the characteristics of substance abuse mothers by reviewing their demographic data collected from 8 HA birthing hospitals; (2) To evaluate the CCDS service by retrieving the maternal and neonatal outcomes; (3) To identify room for further service improvement.
Methodology :
Antenatal and postnatal records of the women who delivered in 8 HA birthing hospitals cared by CCDS under substance abuse category were reviewed and analyzed.
Result & Outcome :
1226 cases were recruited. 8 of them with twin pregnancies were excluded. 1218 cases were in the final cohort.
Amphetamine, Ketamine and Cocaine were the top three commonly abused substances. 45.6% of the women abused more than one substance. For mothers who attended antenatal care, only 26.4% of their babies tested positive for urine toxicology (p<0.001).
98% of the babies were delivered at late preterm and at term (p<0.001). 16.0% of the babies’ birth weight were below the 10th percentile.
95.5% of the babies had their urine sent for toxicology. 38.3% of the babies’ urine found positive to substances. Among babies with urine toxicology positive, the rate of preterm birth was 29%, compared to 9% for babies with negative results. Besides, the rate of low birth weight was 25.3% for positive results, while it was 12.3% for those with negative results. For baby care, only 66.3% of the babies were taken care by mothers or assisted by mother’s family.
In conclusion, with effective counselling, referral and intervention for this high-risk group of pregnant women with substance abuse is an important component of the CCDS program.
