Background Anecdotally there is increasing trend of drug usage in pregnancy and hence neonatal withdrawal (NAS).
There are difficulties in early detection because of a) Reluctance of expectant mothers, late booking and poor attendance at antenatal follow up due to fear of social services.
Objectives 1) Establish prevalence in L&D Hospital.
2) Establish outcomes of urine toxicology (chain of custody in place) and implication on management.
3) Establish transparency in drug users regarding information of drug use.
Methods Retrospective collection of urine toxicology requests to chemical pathology from Feb 2009 to Oct 2012. Requests were based on self-revelation of drug use by pregnant women and of those suspected during antenatal follow up. Data collection using antenatal database (CMIS), South England neonatal database (SEND) and pathology request database, ensuring no loss of data.
Results Total requests: 106. 37% were negative (Some may represent false negatives). Out of 63% positive results, 54% were multidrug users. 72% positive results were not consistent with the substance of use suggested or suspected. None with negative results withdrew and discharged in 2–3 days once results available reducing length of stay. 40% Pregnant on methadone program. Only 11% had an employment or were students. 70% women were single or separated and 25% didn’t disclose their marital status. 19% required treatment.