ROUTINE URINE DRUG SCREENING AT THE 1ST PRENATAL VISIT

OBJECTIVE: The purpose of this study is to determine whether routine urine drug screening at the first prenatal visit will identify and permit early intervention for those at risk for poor outcome. STUDY DESIGN: Comparisons of maternal and neonatal outcomes between 166 randomly chosen patients with positive and 150 randomly chosen patients with negative drug screens identified by the enzyme multiplied immunoassay test were made by unpaired t test, X2 test, probit analysis, and tests of independent Poisson distributions. RESULTS: Forty percent of those identified denied drug use. Antepartum (p < 0.01) and postpartum (p < 0.05) complications were increased among drug users. Birth weight (p < 0.001), gestational age (p < 0.03), and head circumference (p < 0.05) were decreased among neonates. CONCLUSION: Because of difficulty in identifying illicit substance-using patients, consideration should be given to the implementation of routine urine drug screening at the first prenatal visit in populations with a high rate of illicit substance use.