Pubdate: Tue, 30 Mar 2010
Source: Honolulu Star-Bulletin (HI)
Copyright: 2010 Honolulu Star-Bulletin
Contact: http://archives.starbulletin.com/forms/letterform.html
Website: http://www.starbulletin.com/
Details: http://www.mapinc.org/media/196
Author: Helen Altonn

MANY BIG ISLE KIDS HAD PRENATAL SUBSTANCE EXPOSURE

Data for pregnant women on the Big Island suggest about half of the 
island's 37,892 children under age 18 were exposed before birth to 
alcohol, tobacco and illicit drug use, researchers report.

The findings also indicate that of about 2,200 deliveries on the 
island each year, almost 1,100 infants are born exposed.

"We have to find out why this is happening and what effect this is 
having, especially on children," said Dr. Ira Chasnoff, a pediatrics 
professor at the University of Illinois College of Medicine, in a 
telephone interview.

Chasnoff, who is conducting the Big Island project, is one of the 
country's leading researchers on drug use during pregnancy and the 
effects on newborn infants and children. The nonprofit organization 
is concerned with healthy development of children and families.

"We know from other studies what happens to children (prenatally 
exposed to tobacco, alcohol and illicit drugs)," said Chasnoff, who 
is also president of the Children's Research Triangle in Chicago. The 
results are behavioral or learning disorders that are often 
misdiagnosed and treated with inappropriate medications.

"Research shows 60 percent of prenatally exposed children end up in 
jail," he said, adding that programs he developed for children in 
Chicago have significantly reduced that rate.

Projecting effects of the screening data on Big Island children, the 
report says: "Providing intervention and treatment to even a small 
proportion of these children through the mental health, education, 
child welfare and juvenile justice systems may be a driving force in 
the escalating costs for children's behavioral health services that 
are being documented across the state.

"In light of these costs, the need for prevention and earliest 
intervention becomes clear."

The federally funded project involves a comprehensive system of 
screening, assessment and brief intervention for pregnant women from 
some physicians and public health clinics, including private pay and 
Medicaid patients.

"If we find a woman with a positive screen, right there in the 
prenatal care office, providers are trained to do brief 
intervention," said Chasnoff. "It is very successful in motivating 
women to stop using and has been shown to significantly decrease 
rates of prematurity and small birth weight."

Their findings are reported in "The First 1,000 Women; Perinatal 
Substance Use on the Hawaii Island."

A surprise, he said, was the 43.1 percent rate of cigarette smoking 
among native Hawaiian women.

Caucasian and native Hawaiian women had the highest rates of positive 
screens for substance use, with 60 percent prevalence for each group. 
Substances also were used by 48 percent of the pregnant Asian women, 
30 percent of Filipino women and 53 percent of women of mixed race.

Loretta Fuddy, chief of the state Health Department's Family Health 
Services Division, said Chasnoff's figures are a little higher than 
the department has seen through its perinatal risk assessment survey.

She said the important thing about Chasnoff's work is that he 
provides a model for intervention by physicians to try to prevent 
adverse effects.

The Health Department has a perinatal network and provides funding to 
community health centers to screen high risk women for alcohol, 
smoking, illicit drug use and domestic violence, she said.

The agency also is working with the child welfare system to provide 
early intervention services for children under age 3, Fuddy said.

Jackie Berry, executive director of Healthy Mothers, Healthy Babies, 
said Chasnoff's report shows screening works. "A significant 
percentage of women who are told about the effects of substance abuse 
on the fetus stop using whatever they're using. ... Unfortunately, 50 
percent don't."

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ABUSIVE BEHAVIOR

Results of the first 1,000 pregnant women on the Big Island screened 
for alcohol, tobacco and illicit drug use:

The rate of cigarette smoking among native Hawaiian women was 43.1 
percent, and 64.6 percent continued smoking after learning they were pregnant.

Native Hawaiian women had the highest rates of smoking and Caucasian 
women the highest rates of alcohol and marijuana use in the month 
before they knew they were pregnant.

All groups tended to stop substance use after learning they were 
pregnant, but 64.6 percent of Hawaiian women continued to smoke and 
45 percent of Caucasian women continued to drink alcohol.

Source: "The First 1,000 Women; Perinatal Substance Use on Hawaii Island"
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MAP posted-by: Keith Brilhart