Screening for substance use in pregnancy: A practical approach for the primary care physician

Our goal was to identify risk factors for substance use during pregnancy fo r primary care physicians so that we could assess a woman's risk of alcohol or illicit drug use. Participants were 2002 Medicaid-eligible pregnant wom en with less than or equal to2 visits to prenatal care clinics in South Car olina and Washington State. Structured interviews were used to collect data . Logistic regressions and classification and regression trees identified p redictors for pregnant women at high risk for substance use. Approximately 9% of the sample reported current use of either drugs or alcohol or both. P ast use of alcohol or cigarettes, including during the month before pregnan cy, most differentiated current drug or alcohol users from current nonusers . Our analysis suggests that primary care physicians can ask 3 questions in the context of a prenatal health evaluation to target women for referral t o a full clinical assessment for drug and alcohol use.