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Substance Use in Pregnant Women Using the Emergency Department: Undertested And Overlooked?

INTRODUCTION: The objective was to determine if pregnant women visiting the emergency department (ED) are tested for substance use as frequently as non-pregnant women. METHODS: We captured all ED visits over a six-year period (2010–2016) from a single community hospital and identified women of child...

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Autores principales: Moyer, C. Leigh, Johnson, Sean, Klug, Marilyn G., Burd, Larry
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Department of Emergency Medicine, University of California, Irvine School of Medicine 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5942028/
https://www.ncbi.nlm.nih.gov/pubmed/29760859
http://dx.doi.org/10.5811/westjem.2018.1.35630
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author Moyer, C. Leigh
Johnson, Sean
Klug, Marilyn G.
Burd, Larry
author_facet Moyer, C. Leigh
Johnson, Sean
Klug, Marilyn G.
Burd, Larry
author_sort Moyer, C. Leigh
collection PubMed
description INTRODUCTION: The objective was to determine if pregnant women visiting the emergency department (ED) are tested for substance use as frequently as non-pregnant women. METHODS: We captured all ED visits over a six-year period (2010–2016) from a single community hospital and identified women of childbearing age, defined for our study as 11–50 years old. We collected demographic data including age in years, ethnicity, body mass index, marital status, disposition, last encounter department, method of arrival, and day of week. An independent binary variable was created based on whether the woman was tested for alcohol or drugs (amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, opioids) during her visit. We then compared rates of testing for substance use by pregnancy status. RESULTS: We identified 61,222 ED visits by women of childbearing age (range 11–50, mean 30.5, standard deviation 9.6) over a six-year period from 2010–2016. Of the 57,360 non-pregnant women, 4.14% were tested compared to 1.04% of the 3,862 pregnant women tested with a relative risk of 0.25 (p<0.001, 95% confidence interval [CI] [0.183–0.341]). The most highly tested chief complaints for all women – psychiatric or substance use concerns – showed pregnant women were still 37% and 54% less likely to be tested, respectively (risk ratio [RR] 0.46, 95% CI [0.19–1.13]; RR 0.63, 95% CI [0.41–0.96]). Beyond pregnancy status, we found no significant interaction between patient demographics and substance use testing. CONCLUSION: Pregnant women presenting to the ED were 75% less likely to be tested for drug or alcohol use than non-pregnant women. Our study showed only pregnancy status as a statistically significant variable in drug- and alcohol-screening rates when pregnant and non-pregnant patient chief complaints and demographics were compared. Increased attention to the screening of pregnant women for substance use may be necessary to provide adequate care and intervention to this population.
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spelling pubmed-59420282018-05-14 Substance Use in Pregnant Women Using the Emergency Department: Undertested And Overlooked? Moyer, C. Leigh Johnson, Sean Klug, Marilyn G. Burd, Larry West J Emerg Med Behavioral Health INTRODUCTION: The objective was to determine if pregnant women visiting the emergency department (ED) are tested for substance use as frequently as non-pregnant women. METHODS: We captured all ED visits over a six-year period (2010–2016) from a single community hospital and identified women of childbearing age, defined for our study as 11–50 years old. We collected demographic data including age in years, ethnicity, body mass index, marital status, disposition, last encounter department, method of arrival, and day of week. An independent binary variable was created based on whether the woman was tested for alcohol or drugs (amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, opioids) during her visit. We then compared rates of testing for substance use by pregnancy status. RESULTS: We identified 61,222 ED visits by women of childbearing age (range 11–50, mean 30.5, standard deviation 9.6) over a six-year period from 2010–2016. Of the 57,360 non-pregnant women, 4.14% were tested compared to 1.04% of the 3,862 pregnant women tested with a relative risk of 0.25 (p<0.001, 95% confidence interval [CI] [0.183–0.341]). The most highly tested chief complaints for all women – psychiatric or substance use concerns – showed pregnant women were still 37% and 54% less likely to be tested, respectively (risk ratio [RR] 0.46, 95% CI [0.19–1.13]; RR 0.63, 95% CI [0.41–0.96]). Beyond pregnancy status, we found no significant interaction between patient demographics and substance use testing. CONCLUSION: Pregnant women presenting to the ED were 75% less likely to be tested for drug or alcohol use than non-pregnant women. Our study showed only pregnancy status as a statistically significant variable in drug- and alcohol-screening rates when pregnant and non-pregnant patient chief complaints and demographics were compared. Increased attention to the screening of pregnant women for substance use may be necessary to provide adequate care and intervention to this population. Department of Emergency Medicine, University of California, Irvine School of Medicine 2018-05 2018-04-05 /pmc/articles/PMC5942028/ /pubmed/29760859 http://dx.doi.org/10.5811/westjem.2018.1.35630 Text en Copyright: © 2018 Moyer et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/
spellingShingle Behavioral Health
Moyer, C. Leigh
Johnson, Sean
Klug, Marilyn G.
Burd, Larry
Substance Use in Pregnant Women Using the Emergency Department: Undertested And Overlooked?
title Substance Use in Pregnant Women Using the Emergency Department: Undertested And Overlooked?
title_full Substance Use in Pregnant Women Using the Emergency Department: Undertested And Overlooked?
title_fullStr Substance Use in Pregnant Women Using the Emergency Department: Undertested And Overlooked?
title_full_unstemmed Substance Use in Pregnant Women Using the Emergency Department: Undertested And Overlooked?
title_short Substance Use in Pregnant Women Using the Emergency Department: Undertested And Overlooked?
title_sort substance use in pregnant women using the emergency department: undertested and overlooked?
topic Behavioral Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5942028/
https://www.ncbi.nlm.nih.gov/pubmed/29760859
http://dx.doi.org/10.5811/westjem.2018.1.35630
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