Specific guidance for the assessment and
treatment of teenage pregnant substance misusers is needed,
according to a new study.
UK teenage pregnancy and substance misuse
rates are the highest in Western Europe, and result in increasing
numbers of maternal and foetal deaths and illnesses.
This study set out to examine the health and
social characteristics, and treatment, of a population of teenage
pregnant substance misusers to assess whether the available
national guidelines and specific treatment needs are being met.
The researchers carried out a retrospective
record analysis of ten teenage pregnant substance misusers
attending an adolescent substance misusers service in Stoke on
Trent.
They found that the typical patient profile
was characterised by family, education and housing instability.
Violence, divorce or separation, substance misuse and depression in
her parental home were common, as was physical or sexual abuse,
bereavement and poor parental relationships.
She was excluded from school at the age of 14,
took no examinations, and was unemployed. Her partner was 10 years
older than her, unemployed, abusive and an intravenous user who
introduced her to heroin.
She started substance misuse at the age of 12
and attended addiction services by the age of 16. Serious medical
and psychiatric illness, and self-harm, were the norm. Drugs cost
her £160 per week, and she was involved in prostitution.
Her pregnancy was high risk – unplanned, with
late and poor attendance at ante-natal classes, foetal growth
restriction and substance misuse, which continued after birth.
She was offered substitute medication and
support from a multidisciplinary team, and her baby was placed on
the foster care register. The baby, delivered at 38 weeks, was
below the weight expected for its age, and had withdrawal
symptoms.
However, outcomes were positive in this group,
with no maternal, foetal or neonatal deaths.
The researchers comment that this is the first
UK-based study of its type. Available national guidelines
were followed by the health professionals involved, but distinctive
needs among teenage pregnant substance misusers, such as abuse and
bereavement, need to be specifically integrated within such
guidance.
For further information, please contact Liz Fox or Deborah
Hart in the Communications Department.
Telephone: 020 7235 2351 Extensions. 6298 or 6127
References:
Royal College of Psychiatrists’ Annual Meeting, Imperial College London 1 - 4 July 2008