PREDICTORS OF PRENATAL SUBSTANCE USE AND BIRTH-WEIGHT DURING OUTPATIENT TREATMENT

This paper presents evaluation results of a CSAP-funded case managemen t project associated with an outpatient substance abuse treatment (SAT ) program for women and their children. Key findings are: (a) case man agement and threat of child protective services encourage retention in SAT during preg nancy, (b) retention in SAT has a positive effect on reducing illicit substance use, (c) receiving methadone during pregnan cy has a negative effect on reducing illicit substance use, and (d) re duction in illicit substance use has a positive effect on birth weight . These findings indicate retention in SAT and decreased illicit drug use are associated with improved infant birth weight, which is associa ted with other improvements, such as decreased infant mortality and mo rbidity. The finding of a relationship between methadone maintenance t reatment (MMT) and illicit drug use creates a dilemma for practice: to what extent should the dose of methadone be decreased during pregnanc y, given the fact that women may then increase illicit use of drugs. ( C) 1997 Elsevier Science Inc.