Multiple Pregnancies: Determining Chorionicity and Amnionicity
Prevalence of Drug Use in West Virginia Pregnancies
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Prevalence of Drug Use in West Virginia Pregnancies
David Chaffin, MD
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Sponsor
Office of Maternal, Child and Family Health, West Virginia Department of Health and Human Resources
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Selena Johe
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Co-Conspirators
Michael Stitely, MD - WVUByron Calhoun, MD - WVU CharlestonStefan Maxwell, MD - Pediatrix Charleston
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We Have a Problem
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I have no clue about what to do about it.
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Background
Range of reported incidence of drug use in pregnancy 10-14%
Dependence on data collection Survey Samples with consent Anonymous sampling
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Rising incidence of NAS
25
21
48
52
70
0
10
20
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70
2003 2004 2005 2006 2007
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Participating Hospitals
Bluefield Regional (BRMC)Raleigh General (RGH)Thomas Memorial (TMH)Charleston Area Medical Ctr (CAMC)Cabell Huntington HospitalRuby Memorial Hospital (RMH)Wheeling Hospital (WH)City Hospital Martinsburg (CH)
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USDTL CordStat
Drug Class Test Method Cutoff Amphetamines ELISA 5.0 ng/g Cocaines ELISA 2.0 ng/g Opiates ELISA 2.0 ng/g Cannabinoids ELISA 100 pg/g Benzodiazepines ELISA 2.0 ng/g Methadones ELISA 2.0 ng/g Buprenorphines LCMSMS 2.0 ng/g Alcohol ELISA
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Study Limitations
No other informationNo account for legal use
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Final Result
146 of 759 cord samples positive for drugs or alcohol
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759 Samples: Drugs + Alcohol
BRMC 50 samples 16%RGH 83 20TMH 59 19CAMC 133 22CHH 245 18RMH 52 17WH 65 28CH 72 13
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759 Samples: Drugs + Alcohol
Drugs AlcoholBRMC 14 % 4%RGH 19 2TMH 10 8CAMC 16 8CHH 17 1RMH 13 4WH 12 15CH 10 5
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USDTL CordStat
Drug Class Number Amphetamines 1 Cocaines 0 Opiates 41 Cannabinoids 58 Benzodiazepines 17 Methadones 14 Buprenorphine 0 Alcohol 39
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Distribution of Drugs
Opiates
24%
THC
35%
Benzos
10%
Methadone
8%
EtOH
23%
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Polysubstance abuse
0
5
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20
25
30
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CHH Neonates vs Cord Study
05
10152025303540
Number affected
AmphetaminesBenzodiazepines
CocaineMarijuanaMethadoneOpiatesAlcohol
Mother Cord
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Lessons
1 in 5 babies in WV exposed to drugs or alcohol
Polypharmacy is commonThere are regional distributions of drug
use
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We have a problem