BRIEF INTERVENTION FOR DRUG USE IN PREGNANT WOMEN

描述：（申请人摘要） 产前药物使用与各种医疗和发育相关， 后果 虽然许多妇女自发地放弃物质的使用， 其他人在得知自己怀孕后，在整个怀孕期间继续使用。 与酒精和烟草相比，人们对产前戒烟知之甚少 非法药物使用率。 此外，人们对 酒精和烟草使用对产前非法药物使用的影响，以及 造成能力差异的心理和其他因素 孕妇停止使用非法药物。 最后，更好的干预措施 提高产前药物使用戒烟率。 目前 最常见的干预措施是简短的专业建议（BPA）， 有限的临床效果。 为了解决这些问题，A 将进行随机分配临床试验，以评估 两种有前途的干预措施的有效性， 减少产前阿片类药物和/或可卡因使用的力度。 受试者将 社会经济地位较低、高中以下学历的孕妇 教育（入院时估计胎龄20周）。 受试者 将随机选择孕前/产前阿片类药物和/或可卡因使用情况 分配到三个干预组之一（N=237/组）：（1）仅BPA （标准医疗实践）;（2）BPA与行为 激励（BI）;（3）BPA与BI和激励相结合 增强治疗（MET）。 将前瞻性随访受试者 在整个怀孕期间和产后期间， 发生在物质使用中。 自我报告和客观测量 将使用物质。 该研究还将确定心理 以及其它因素（例如，抑郁症，母婴互动，药物使用 由重要的其他），影响戒烟和复发产前 物质使用。 非阿片类药物/可卡因使用者的对照组（N=237）将 评估产前使用阿片类药物和/或可卡因对 产妇和婴儿的结果。 该研究还将确定影响 怀孕前物质使用对怀孕内非法戒烟率的影响 吸毒以及戒烟对母婴健康的影响。

DESCRIPTION: (Applicant's Abstract) Prenatal drug use is associated with a variety of medical and developmental consequences. Although many women spontaneously quit substance use on learning they are pregnant, others continue to use throughout pregnancy. Compared to alcohol and tobacco, little is known about prenatal quitting rates for illicit drug use. Also, little is known about the influence of alcohol and tobacco use on prenatal illicit drug use, and about psychological and other factors that account for the differences in ability of pregnant women to quit illicit drug use. Finally, better interventions are needed to enhance prenatal substance use quitting rates. Currently, the most common intervention is brief professional advice (BPA), which has only limited clinical effectiveness. To address these issues, a random-assignment clinical trial will be conducted to assess the effectiveness of two promising interventions of increasing clinical intensity on reducing prenatal opiate and/or cocaine use. Subjects will be pregnant women of lower socioeconomic status with less than a high school education (estimated gestational age at admission 20 weeks). Subjects with pre-pregnancy/prior prenatal opiate and/or cocaine use will be randomly assigned to one of three intervention groups (N=237/group): (1) BPA only (standard medical practice); (2) BPA in combination with behavioral incentives (BI); and (3) BPA in combination with BI and Motivational Enhancement Therapy (MET). Subjects will be followed prospectively throughout pregnancy and into the post partum period to determine changes that occur in substance use. Both self-report and objective measures of substance use will be employed. The study will also identify psychological and other factors (e.g., depression, maternal-infant interactions, drug use by significant other) that influence quitting and relapse to prenatal substance use. A comparison group of non-opiate/cocaine users (N=237) will be included to assess effects of prenatal opiate and/or cocaine use on maternal and infant outcomes. The study will also determine the influence of pre-pregnancy substance use on within-pregnancy quitting rates of illicit drug use, and the impact of quitting on maternal and infant health.