Authors (including presenting author) :
Chow SY(1), Ho, LF(1), Yeung LM(1), Leung CYJ(2), Siu YLC(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), Chan LSL(6), KOO MW(6), Yau YY(6), Yu KL(6), Lai S(7), Lok YY(7), Leung SK(8), Ip LS(8)
Affiliation :
(1)Queen Mary Hospital, (2)Princess Margaret Hospital, (3)Prince of Wales Hospital, (4)Pamela Youde Nethersole Eastern Hospital, (5)Queen Elizabeth Hospital, (6)Kwong Wah Hospital, (7)Tuen Mun Hospital, (8)United Christian Hospital
Introduction :
Substance abuse during pregnancy is a significant public health problem, resulting in adverse maternal and child health. Comprehensive Child Development Services (CCDS) is a government funded programme which provides social and medical services to pregnant women with substance abuse problems. CCDS midwives provide comprehensive maternity care to this group of women in antenatal and early postnatal period. This study is the first territory-wide review of pregnant women with drug abuse under the care of CCDS in 8 Hospital Authority (HA) birthing hospitals.
Objectives :
The aim of this study is to review demographic characteristics of women with substance abuse under CCDS care, determine risk factors, explore commonly used substances and evaluate maternal pregnancy outcomes.
Methodology :
This is a retrospective, cohort study of women with substance abuse, delivered at 8 HA birthing hospitals, and under the care of the CCDS team within the study period from 2017 to 2021. Data was retrieved from patients’ clinical records.
Result & Outcome :
Total 1218 eligible subjects in the final cohort were analysed. The incidence of pregnant women with substance abuse remained relatively stable at 0.78% within the study period. The incidence varied among 7 clusters, ranged from 0.54% to 1.77%.
43.8% (534/1218) and 30.9% (376/1218) of women in the study were unemployed and housewife respectively. However, only 21.5% (262/1218) reported to be the recipient of Comprehensive Social Security Assistance (CSSA). The incidence of unplanned pregnancy was high (84%, 1033/1218), this signifies the need of more accessible family planning services to this group of women. 85.3% (1040/1218) of women were active smokers which posed additional risks to their pregnancies and unborn babies.
The substance abuser was identified according to the results of urine toxicology, which was voluntary for women under the care of CCDS. Within the study period, the most commonly abused substances were amphetamine (56.7%, 691/1218), ketamine (39.6%, 482/1218) and cocaine (36.9%, 449/1218). 45.6% (556/1218) of women had used more than one substance.
73.9% (898/1218) of women received antenatal care under the CCDS service. They were more likely to have negative urine toxicology results than those who received no antenatal care (56.7%% vs 18.4%, p<0.001). Receiving CCDS services appeared to be beneficial in supporting pregnant women to remain abstinence.
