Royal College of Psychiatrists: Specific guidance needed for treating teenage pregnant substance misusers

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Friday, 04, Jul 2008 12:00

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.

Reference:

Royal College of Psychiatrists’ Annual Meeting, Imperial College London 1 - 4 July 2008

For further information contact Prof Ilana Crome, University Medical School, Staffordshire.

Tel: 01782 441 658 or 07734 061 158. E-mail: i.crome@psych.keele.ac.uk

Royal College of Psychiatrists’ Press Office: 020 7235 2351 exts. 298 or 127.

From 1-4 July, please call the Annual Meeting Press Office on 020 7594 8636 or 020 7594 1847.