Incidence of narcotic abuse during pregnancy in northwestern Ontario: three-year prospective cohort study

Len Kelly; John Guilfoyle; Joe Dooley; Irwin Antone; Lianne Gerber-Finn; Roisin Dooley; Nicole Brunton; Kara Kakegamuck; Jill Muileboom; Wilma Hopman; Helen Cromarty; Barb Linkewich; Jennifer Maki

Incidence of narcotic abuse during pregnancy in northwestern Ontario: three-year prospective cohort study

Can Fam Physician. 2014 Oct;60(10):e493-8.

Authors

Affiliations

¹ Professor in the Division of Clinical Sciences at the Northern Ontario School of Medicine and a rural physician and clinical researcher in Sioux Lookout, Ont. lkelly@mcmaster.ca.
² Assistant professor at Northern Ontario School of Medicine and rural family physician in Sioux Lookout.
³ Medical student at the University of British Columbia in Prince George.
⁴ Research intern at the Sioux Lookout Meno Ya Win Health Centre (SLMHC).
⁵ Medical student at the University of Ottawa in Ontario.
⁶ Research intern at the SLMHC.
⁷ Epidemiologist at Kingston General Hospital and in the Department of Community Heath and Epidemiology at Queen's University in Kingston, Ont.
⁸ Special Advisor in First Nations Health at the SLMHC at the time of the study.
⁹ Vice President of Patient Services and Clinical Research at the SLMHC at the time of the study.
¹⁰ Vice President of Quality and Clinical Support Services at the SLMHC.

PMID: 25316764
PMCID: PMC4196835

Abstract
in English, French

Objective: To document the incidence and outcomes of narcotic use during pregnancy in northwestern Ontario.

Design: Three-year prospective cohort study.

Setting: Sioux Lookout and surrounding communities in northwestern Ontario.

Participants: A total of 1206 consecutive births in a catchment area of 28 000 First Nations patients.

Main outcome measures: Incidence of narcotic use, and maternal and neonatal outcomes.

Results: Incidence of narcotic use in pregnancy has risen to 28.6% (P < .001) and incidence of neonatal abstinence syndrome has fallen to 18.0% of narcotic-exposed births (P = .003). Daily intravenous drug use is now a common pattern of abuse.

Conclusion: Narcotic abuse in pregnancy has dramatically increased in northwestern Ontario. Neonatal outcomes have improved as a result of a family medicine-based prenatal and obstetric program that includes a narcotic replacement and tapering program.

Objectif: Documenter l’incidence et les issues de l’utilisation de narcotiques durant la grossesse dans le nord-ouest de l’Ontario.

Type d’étude: Étude de cohorte prospective d’une durée de 3 ans.

Contexte: Sioux Lookout et les communautés des environs dans le nord-ouest de l’Ontario.

Participants: Un total de 1206 naissances consécutives dans une circonscription hospitalière comprenant 28 000 patients des Premières Nations.

Principaux paramètres à l’étude: L’incidence de l’usage de narcotiques et les issues maternelles et néonatales.

Résultats: La consommation de narcotiques pendant la grossesse s’élève à 28,6 % (P < ,002) alors que l’incidence du syndrome de sevrage du nouveau-né a chuté pour atteindre 18,0 % des naissances exposées aux narcotiques (P = ,003). L’utilisation quotidienne de drogues par injection est maintenant un mode courant de consommation.

Conclusion: La consommation de narcotiques durant la grossesse a augmenté de façon spectaculaire dans le nord-ouest de l’Ontario. Les issues néonatales se sont toutefois améliorées en raison d’un programme prénatal et obstétrical de médecine familiale basé sur un remplacement des narcotiques et un sevrage progressif.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Female
Humans
Incidence
Indians, North American / ethnology
Narcotics / toxicity
Neonatal Abstinence Syndrome / epidemiology
Ontario / epidemiology
Opioid-Related Disorders / epidemiology*
Pregnancy
Pregnancy Complications / epidemiology*
Prospective Studies
Substance-Related Disorders / epidemiology

Substances

Narcotics

Abstract in English, French

Publication types

MeSH terms

Substances

Abstract
in English, French