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Postpartum psychoactive substance abuse after severe maternal morbidity
Author(s) -
Pereira Cynara M.,
Pacagnella Rodolfo C.,
Parpinelli Mary A.,
Andreucci Carla B.,
Zanardi Dulce M.,
Souza Renato T.,
Angelini Carina R.,
Silveira Carla,
Cecatti José G.
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12967
Subject(s) - medicine , pregnancy , substance abuse , retrospective cohort study , obstetrics , drug , postpartum period , intervention (counseling) , psychiatry , genetics , biology
Abstract Objective To evaluate drug use among mothers during the postpartum period after a severe pregnancy‐related complication. Methods A retrospective cohort study of maternal morbidity including maternal near‐miss and control groups conducted in a tertiary hospital in Campinas, Brazil, between July 2008 and June 2012. The Alcohol, Smoking, and Substance Involvement Screening Test ( ASSIST ) was used to assess drug use during lifetime, pregnancy, and in the previous 3 months. Results Of 638 women evaluated, drug use was reported by 165 (25.8%). Alcohol was the most common substance used (n=133, 20.6%), followed by tobacco (n=85, 13.2%), and cocaine (n=15, 2.3%). The highest risk for postpartum drug use was among those using drugs during pregnancy. There were no differences between the morbidity and control groups, but there was a significant difference in the need for intervention to reduce alcohol consumption in the severe maternal morbidity group. Risk for substance abuse intervention increased three‐fold in women with PTSD criteria, and all aspects of quality of life were worse among drug users. Conclusion Drug use during pregnancy and maternal complications are linked to postpartum drug abuse. These women should be managed during pregnancy; postpartum follow‐up requires updated guidance and must go beyond family planning.