Examining the "cost" of substance abuse in pregnancy: patient outcomes and resource utilization.

OBJECTIVE

This study investigated the clinical and financial impact of self-reported maternal drug history and documented intrauterine substance exposure on maternal-neonatal morbidity and hospital costs.

STUDY DESIGN

This two-part, case-controlled, retrospective study used matching control groups.

RESULTS

Among women reporting a history of substance abuse during or prior to the index pregnancy, (a) maternal hospital costs were significantly higher and more variable; (b) birth weight, length, and gestational age were lower; (c) no significant differences were noted in the number of maternal risk factors or neonatal complications and hospital costs. In comparison of neonates with positive toxicology screens and a matched control group, there were no differences in neonatal outcomes or costs, but the number of complicating maternal risk factors and maternal hospital costs were significantly different.

CONCLUSION

Knowledge of maternal substance abuse history may be useful in planning for maternal-neonatal care needs and reimbursement for hospital care for this at-risk patient population.