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Substance abuse treatment linked with prenatal visits improves perinatal outcomes: a new standard

An Erratum to this article was published on 28 January 2009



To evaluate the impact of Early Start, an obstetric clinic-based prenatal substance abuse treatment program, on perinatal outcomes.

Study Design:

Subjects were 49 985 women who completed Prenatal Substance Abuse Screening Questionnaires at obstetric clinics between 1 January 1999 and 30 June 2003, had urine toxicology screening tests and either live births or intrauterine fetal demises (IUFDs). Four groups were compared: women screened/assessed positive and treated by Early Start (‘SAT’, n=2073); women screened/assessed positive without treatment (‘SA’, n=1203); women screened positive only (‘S’, n=156); controls who screened negative (n=46 553). Ten neonatal and maternal outcomes were studied.


SAT women had either similar or slightly higher rates than the control women on most outcomes but significantly lower rates than S women. SA women generally had intermediate rates to the SAT and S groups. In multivariate analysis, the S group had significantly worse outcomes than the SAT group: preterm delivery (odds ratio (OR)=2.1, 1.3 to 3.2), placental abruption (OR=6.8, 3.0 to 15.5) and IUFD (OR=16.2, 6.0 to 43.8).


Substance abuse treatment integrated with prenatal visits was associated with a positive effect on maternal and newborn health.

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This project was supported by a grant from the Direct Community Benefit Investment Fund of the Kaiser Foundation Research Institute, Oakland, CA.

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Correspondence to N C Goler.

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Goler, N., Armstrong, M., Taillac, C. et al. Substance abuse treatment linked with prenatal visits improves perinatal outcomes: a new standard. J Perinatol 28, 597–603 (2008).

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  • prenatal substance abuse
  • program evaluation
  • prenatal care
  • pregnancy complications
  • neonatal outcomes
  • maternal outcomes

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