Improving Outcome of Children Born
to Drug-Dependent Mothers
Loretta P. Finnegan, M.D.
Karol A. Kaltenbach, Ph.D.
Matthew Pasto, M.D.,
Leonard Graziani, M.D.,
Dianne O'Malley Regan, R.N., M.S.W.
Sandra L. Tunis, Ph.D.
Numerous investigators have reported an extremely high incidence of medical and obstetrical complications among pregnant drug‐ dependent women and high levels of morbidity and mortality among passively addicted infants. Opiate dependence in the pregnant woman is overwhelming to her own physical condition as well as to that of the fetus and eventually the newborn infant. In addition, drug-dependent mothers tend to neglect prenatal care as well as their general health care, and many abuse more than one drug (Connaughton et al., 1977; Finnegan, 1978; Finnegan and Fehr, 1980; Finnegan et al., 1977; Wapner and Finnegan, 1982). Perinatal management of drug-dependent women is further complicated by the frequency with which they experience psychiatric, psychological, and social difficulties.
In an effort to provide comprehensive services for this high-risk population of drug‐ dependent women and their infants, the Family Center Program was established to provide necessary medical, psychiatric, and social services as well as a variety of clinical assessments. Outpatient methadone maintenance is available for the drug-dependent women and, where appropriate, for their husbands or partners. Within the clinical setting of the Program, our studies have taught us much about the characteristics and needs of these women and about the medical and developmental outcome of their children. This report summarizes four aspects of our research: (1) the incidence of violence and depression among women enrolled in the Program and its possible relation to parenting effectiveness; (2) maternal perceptions of their newborns; (3) brain growth and cerebral ventricular development in the passively addicted infants; and (4) long-term outcome measures of mental development.
Experiences with Violence in
In treating pregnant drug addicts, it is particularly important to assess the degree to which depression is present. Among addicts, women experience substantially more depression than do men (Reed et al., 1977). Furthermore, de