Perinatal Illicit Drug and Marijuana Use: An Observational Study Examining Prevalence, Screening, and Disclosure
Perinatal Illicit Drug and Marijuana Use: An Observational Study Examining Prevalence, Screening, and Disclosure
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DOI：
10.4278/ajhp.141215-qual-625
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发表时间：
2017-01-01
影响因子：
2.7
通讯作者：
Arnold, Robert M.
中科院分区：
文献类型：
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作者：
Chang, Judy C.;Holland, Cynthia L.;Arnold, Robert M.
目的.评估使用，筛选和披露围产期大麻和其他非法药物在第一次产科访问。观察性研究，定性评估供应商筛选和患者披露的物质使用。研究地点是位于宾夕法尼亚州匹兹堡的五个城市产前门诊诊所和诊所。孕妇和产科提供者被招募为参与者。我们在第一次产科访问期间录音患者-提供者对话，并获得患者尿液样本用于药物分析。对录音进行审查，以供提供者筛选和患者披露非法药物使用情况。将尿液分析与音频记录进行比较以确定准确性。422名孕妇提供了完整的录音和尿液样本进行分析。在81%的访问中，提供者询问了非法药物使用情况。123名患者（29%）披露了任何当前或过去的非法药物使用; 48名患者（11%）披露了当前在怀孕期间使用大麻。145个样本（34%）对一种或多种物质检测呈阳性;大麻是最常见的检测（N = 114，27%）。在任何物质检测呈阳性的患者中，66人（46%）没有透露任何用途;只有36%的大麻检测呈阳性的患者透露了目前的用途。虽然大麻在宾夕法尼亚州是非法的，但很高比例的怀孕患者使用大麻，许多人没有向产科护理提供者透露使用情况。
Purpose. To assess use, screening, and disclosure of perinatal marijuana and other illicit drugs during first obstetric visits.Design. Observational study that qualitatively assesses provider screening and patient disclosure of substance use.Setting. Study sites were five urban outpatient prenatal clinics and practices located in Pittsburgh, Pennsylvania.Participants. Pregnant patients and obstetric providers were recruited as participants.Methods. We audio recorded patient-provider conversations during first obstetric visits and obtained patient urine samples for drug analyses. Audio recordings were reviewed for provider screening and patient disclosure of illicit drug use. Urine analyses were compared with audio recordings to determine disclosure.Results. Four hundred and twenty-two pregnant patients provided complete audio recordings and urine samples for analyses. Providers asked about illicit drug use in 81% of the visits. One hundred twenty-three patients (29%) disclosed any current or past illicit drug use; 48 patients (11%) disclosed current use of marijuana while pregnant. One hundred and forty-five samples (34%) tested positive for one or more substances; marijuana was most commonly detected (N = 114, 27%). Of patients who tested positive for any substance, 66 (46%) did not disclose any use; only 36% of patients who tested positive for marijuana disclosed current use.Conclusion. Although marijuana is illegal in Pennsylvania, a high proportion of pregnant patients used marijuana, with many not disclosing use to their obstetric care providers.