SOMANZ Poster Presentation Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2025

Maternal health and pregnancy and birth outcomes in women who use alcohol and other drugs (#175)

Kelly A McNamara 1 2 , Kirsten I Black 2 3 , Bridin Murnion 2 4 , Antonia Shand 2 5 , Amanda Henry 6 7 , Joanne Ludlow 3 , Kelly Hankins 1 8 , Rashna Chinoy 9 10 , Natasha Nassar 11 12
  1. School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
  2. Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
  3. RPA Women's and Babies, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
  4. School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, NSW, Australia
  5. Department of Maternal Fetal Medicine, Royal Hospital for Women, Randwick, NSW, Australia
  6. Department of Obstetrics and Gynaecology, St George Hospital, Kogarah, NSW, Australia
  7. The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
  8. Department of Obstetrics and Gynaecology, Gosford Hospital, Gosford, NSW, Australia
  9. Department of Obstetrics and Gynaecology, Wollongong Hospital, Wollongong, NSW, Australia
  10. Department of Obstetrics and Gynaecology, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia
  11. Child population and Translational Health Research, Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health,, University of Sydney, Sydney, NSW, Australia
  12. Leeder Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia

Background: The maternal health of women who use alcohol and other drugs (AOD) in pregnancy is poorly described.  This study examines those associations, as well as maternal and neonatal outcomes. 

Methods:  This was a retrospective cohort study using data collected by pregnancy care providers from four NSW Local Health Districts from 2017 to 2020.  We identified women with a substance use disorder (SUD), women with significant AOD use but not an SUD, and women who used tobacco only.  We examined a range of physical, mental and reproductive health factors and explored associations with maternal and neonatal outcomes.

Results: From 57475 mothers, 454 had a SUD (0.8%), 1155 (2.0%) had significant AOD use, 3880 (6.8%) used tobacco only. Compared to women with low level alcohol or no AOD use, women with all other patterns of AOD use had higher Edinburgh depression scores, more iron-deficiency anaemia, more musculo-skeletal and respiratory diseases, and lower cervical screening rates. The women had longer length of stay (LOS) (aOR 1.46-4.16) and their babies had increased odds of being small for gestational age (aOR 2.06-3.87), preterm birth before 37 completed weeks (aOR 1.52-2.69), 5-minute Apgar scores < 7 (aOR 1.32-2.03), child protection involvement (aOR 3.85-10.63), and longer LOS (aOR 1.62-4.47).

Conclusions: Women with all patterns of AOD use had poorer baseline maternal health and worse perinatal outcomes. These women need access to multidisciplinary holistic pregnancy care including obstetric and drug health support.