National guidelines for the management of drug use during pregnancy

Problematic drug use in the pregnant population has been associated with:

• spontaneous abortions
• hypertension
• blood borne viruses
• prematurity or low birth weight babies
• still births
• infants withdrawing from exposure to the mother's drug use
• sudden infant death syndrome.

In addition, alcohol use during pregnancy can result in babies being born with fetal alcohol spectrum disorder. In cases where alcohol or drugs were used in the pregnancy, babies could have feeding or sleep-pattern problems which could make them difficult to manage, interfering with breastfeeding and mother-infant attachment.

Using drugs can interfere with good parenting and many drug users have social, economic or other problems associated with their drug-using lifestyle that can contribute to poorer maternal and infant health and child development.

In Australia, concern about the negative consequences of drug misuse provoked strong support from all jurisdictions for the development of national guidelines. It will enable a comprehensive, consistent approach to the care and management of pregnant drug using women antenatally, at birth, postnatally and in the child's early developmental years.

To respond to these concerns, a national project was created under the Ministerial Council on Drug Strategy (MCDS) Cost Shared Funding Model to establish national guidelines for the care of this patient group. The "National clinical guidelines for the management of drug use during pregnancy, birth and the early development years of the newborn" was subsequently developed. The guidelines are largely evidence-based and where the evidence was not available consensus was reached by a team of experts in the field.

The guidelines consider the risk and management of a range of substances used during pregnancy including the treatment of opioid dependence. Other issues are addressed as well, including:

• engaging women in a therapeutic relationship
• providing continuity of care
• screening and assessment
• mental health problems
• drug-relapse intervention
• withdrawal care (detoxification during pregnancy)
• blood borne viruses
• breastfeeding
• Neonatal Abstinence Syndrome
• pain management
• vaccinations
• indigenous population issues.

The guidelines are intended for use by all health care practitioners working with pregnant women who have substance use problems.

The Queensland launch of the National Guidelines was held on 9 June 2006 at Mater Mothers' Hospital. Information on these Guidelines can be obtained through Mater Mothers' Hospital by contacting 07 3163 8111 or the Alcohol, Tobacco and Other Drugs Services (ATODS).

Alternatively, please visit:

http://www.health.nsw.gov.au/pubs/2006/ncg_druguse.html or download the document in PDF.