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Predictors of Inadequate Prenatal Care in Methamphetamine-Using Mothers in New Zealand and the United States

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Abstract

This study compared patterns of prenatal care among mothers who used methamphetamine (MA) during pregnancy and non-using mothers in the US and New Zealand (NZ), and evaluated associations among maternal drug use, child protective services (CPS) referral, and inadequate prenatal care in both countries. The sample consisted of 182 mothers in the MA-Exposed and 196 in the Comparison groups in the US, and 107 mothers in the MA-Exposed and 112 in the Comparison groups in NZ. Positive toxicology results and/or maternal report of MA use during pregnancy were used to identify MA use. Information about sociodemographics, prenatal care and prenatal substance use was collected by maternal interview. MA-use during pregnancy is associated with lower socioeconomic status, single marital status, and CPS referral in both NZ and the US. Compared to their non-using counterparts, MA-using mothers in the US had significantly higher rates of inadequate prenatal care. No association was found between inadequate care and MA-use in NZ. In the US, inadequate prenatal care was associated with CPS referral, but not in NZ. Referral to CPS for drug use only composed 40 % of all referrals in the US, but only 15 % of referrals in NZ. In our study population, prenatal MA-use and CPS referral eclipse maternal sociodemographics in explanatory power for inadequate prenatal care. The predominant effect of CPS referral in the US is especially interesting, and should encourage further research on whether the US policy of mandatory reporting discourages drug-using mothers from seeking antenatal care.

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Acknowledgments

The official name of the project is Prenatal Methamphetamine Exposure and Child Development in New Zealand and USA. This study was supported by a grant from the National Institute on Drug Abuse (Grant #R01DA021757) and a US Graduate Student grant from the Fulbright New Zealand Programme. We thank Carolyn Ho, Jenny Rogers, Jo Cliffe, Sue Cumming, Gillian Gee, Christine Todd, and Heather Stewart in Auckland, New Zealand for their assistance in this international collaboration.

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Authors and Affiliations

  1. Brown Center for the Study of Children at Risk, Warren Alpert Medical School at Brown University and Women and Infants Hospital, Providence, RI, USA

    Min Wu, Linda L. LaGasse, Tara Wilcox, Sheri DellaGrotta & Barry M. Lester

  2. Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

    Trecia A. Wouldes

  3. Family Science Department, Center on Young Adult Health and Development, University of Maryland School of Public Health, College Park, MD, USA

    Amelia M. Arria

  4. Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA

    Chris Derauf & Charles R. Neal

  5. Department of Psychology, The University of Tulsa, Tulsa, OK, USA

    Elana Newman

  6. Blank Hospital Regional Child Protection Center - Iowa Health, Des Moines, IA, USA

    Rizwan Shah

  7. Department of Pediatrics, LABioMed Institute at Harbor-UCLA Medical Center and David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Lynne M. Smith

  8. Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA

    Marilyn A. Huestis

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  1. Min Wu
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Correspondence to Min Wu.

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Wu, M., LaGasse, L.L., Wouldes, T.A. et al. Predictors of Inadequate Prenatal Care in Methamphetamine-Using Mothers in New Zealand and the United States. Matern Child Health J 17, 566–575 (2013). https://doi.org/10.1007/s10995-012-1033-8

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