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Research ArticleResearch

Incidence of narcotic abuse during pregnancy in northwestern Ontario

Three-year prospective cohort study

Len Kelly, John Guilfoyle, Joe Dooley, Irwin Antone, Lianne Gerber-Finn, Roisin Dooley, Nicole Brunton, Kara Kakegamuck, Jill Muileboom, Wilma Hopman, Helen Cromarty, Barb Linkewich and Jennifer Maki
Canadian Family Physician October 2014; 60 (10) e493-e498;
Len Kelly
Professor in the Division of Clinical Sciences at the Northern Ontario School of Medicine and a rural physician and clinical researcher in Sioux Lookout, Ont.
MD MClSc FCFP FRRM
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  • For correspondence: lkelly@mcmaster.ca
John Guilfoyle
Assistant professor at Northern Ontario School of Medicine and rural family physician in Sioux Lookout.
MD CCFP FCFP
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Joe Dooley
Assistant professor at Northern Ontario School of Medicine and rural family physician in Sioux Lookout.
MD CCFP FCFP
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Irwin Antone
Assistant professor at Northern Ontario School of Medicine and rural family physician in Sioux Lookout.
MD CCFP FCFP
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Lianne Gerber-Finn
Assistant professor at Northern Ontario School of Medicine and rural family physician in Sioux Lookout.
MD CCFP FCFP
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Roisin Dooley
Medical student at the University of British Columbia in Prince George.
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Nicole Brunton
Research intern at the Sioux Lookout Meno Ya Win Health Centre (SLMHC).
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Kara Kakegamuck
Medical student at the University of Ottawa in Ontario.
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Jill Muileboom
Research intern at the SLMHC.
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Wilma Hopman
Epidemiologist at Kingston General Hospital and in the Department of Community Heath and Epidemiology at Queen’s University in Kingston, Ont.
MA
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Helen Cromarty
Special Advisor in First Nations Health at the SLMHC at the time of the study.
RN
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Barb Linkewich
Vice President of Patient Services and Clinical Research at the SLMHC at the time of the study.
RN
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Jennifer Maki
Vice President of Quality and Clinical Support Services at the SLMHC.
MSc
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Article Figures & Data

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    Figure 1.

    Proportion of narcotic-exposed neonates during consecutive 6-month periods from January 1, 2009, to June 30, 2013: P < .001 when comparing the period from January 2009 to June 2010 and the period from July 2010 to June 2013.

    Data for January 2009 to June 2010 from Kelly et al3.

  • Figure 2.
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    Figure 2.

    Patterns of use of narcotics in pregnancy: P < .001 when comparing the 2 time periods.

    Data for January 2009 to June 2010 from Kelly et al.3

Tables

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    Table 1.

    Maternal characteristics: Significance tests for age, parity, and gestational age are based on t tests; the rest are based on χ2 tests.

    CHARACTERISTICTOTAL PREGNANCIES N = 1206EXPOSED PREGNANCIES N = 300P VALUE
    Mean (SD) age, y24.6 (5.9)24.2 (4.7).088
    Mean (SD) parity2.8 (1.8)2.9 (1.7).152
    Mean (SD) gestational age, wk38.9 (1.5)38.9 (1.3).825
    Smoking, n (%)672 (55.7)250 (83.3)< .001*
    Alcohol consumption, n (%)225 (18.7)39 (13.0).003*
    Hypertension, n (%)70 (5.8)19 (6.3).657
    Type 2 diabetes mellitus, n (%)38 (3.2)13 (4.3).184
    Gestational diabetes, n (%)90 (7.5)20 (6.7).533
    Cesarean section, n (%)305 (25.3)74 (24.7).774
    Nonelective cesarean section, n (%)193 (16.0)51 (17.0).497
    Out-of-hospital delivery, n (%)36 (3.0)4 (1.3).052
    Postpartum hemorrhage, n (%)112 (9.3)28 (9.3).978
    • ↵* Statistically significant difference between exposed and nonexposed pregnancies.

    • View popup
    Table 2.

    Neonatal characteristics: Significance tests for birth weight, Apgar score, head circumference, length, and blood pH are based on t tests; the rest are based on χ2 tests.

    CHARACTERISTICTOTAL PREGNANCIES N = 1206EXPOSED PREGNANCIES N = 300PVALUE
    Mean (SD) birth weight, g3526.3 (556.1)3420.8 (538.6)< .001*
    Mean (SD) Apgar score at 1 min8.5 (1.1)8.5 (1.3).794
    Mean (SD) Apgar score at 5 min9.0 (0.5)8.9 (0.7).148
    Mean (SD) head circumference, cm35.0 (1.7)34.8 (1.5).103
    Mean (SD) length, cm50.9 (3.2)50.5 (3.2).011*
    Mean (SD) arterial pH7.24 (0.09)7.25 (0.08).211
    Mean (SD) venous pH7.30 (0.24)7.31 (0.08).254
    Preterm birth (< 37 wk), n (%)54 (4.5)16 (5.3).408
    NAS, n (%)54 (4.5)54 (18.0)< .001*
    Finnegan score ≥ 8,† n (%)32 (2.7)32 (10.7)< .001*
    Male sex, n (%)596 (49.4)136 (45.3).099
    Transfers out, n (%)18 (1.5)8 (2.7).093
    Stillbirths, n (%)12 (1.0)3 (1.0)1.0
    • NAS—neonatal abstinence syndrome.

    • ↵* Statistically significant difference between exposed and nonexposed pregnancies.

    • ↵† Finnegan scores ≥ 8 indicate a need for pharmacologic treatment of the neonate for NAS.

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Canadian Family Physician: 60 (10)
Canadian Family Physician
Vol. 60, Issue 10
1 Oct 2014
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Incidence of narcotic abuse during pregnancy in northwestern Ontario
Len Kelly, John Guilfoyle, Joe Dooley, Irwin Antone, Lianne Gerber-Finn, Roisin Dooley, Nicole Brunton, Kara Kakegamuck, Jill Muileboom, Wilma Hopman, Helen Cromarty, Barb Linkewich, Jennifer Maki
Canadian Family Physician Oct 2014, 60 (10) e493-e498;

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Incidence of narcotic abuse during pregnancy in northwestern Ontario
Len Kelly, John Guilfoyle, Joe Dooley, Irwin Antone, Lianne Gerber-Finn, Roisin Dooley, Nicole Brunton, Kara Kakegamuck, Jill Muileboom, Wilma Hopman, Helen Cromarty, Barb Linkewich, Jennifer Maki
Canadian Family Physician Oct 2014, 60 (10) e493-e498;
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