In the first urine screening of pregnant women in Denmark specifically targeted at non-prescribed drugs, seven per cent of the tested women tested positive. (Photo: Shutterstock)

Surprisingly many women tested positive for drug use during pregnancy

A new study finds that many pregnant women tested positive for addictive drugs, begging the question, should pregnant women be routinely tested for drugs?

Most of us probably know that it is not a good idea to take drugs or addictive medicine whilst pregnant. But apparently there is still a surprising number of pregnant women who do just that.

In a recent study, scientists conducted urine tests on a random sample of pregnant women and were surprised to find that many women tested positive for a range of drugs.

"We were very surprised to find so many pregnant women had taken drugs that weren’t prescribed by their doctor. This was considerably more than we had expected," says co-author Inge Olga Ibsen, a consultant in gynaecology and obstetrics and head of the Family Clinic at South Denmark Hospital.

Urine samples contained morphine and cannabis

The study, which is supported by the Tryg Foundation in Denmark, was conducted on a single day in 2013. Ibsen and colleagues tested the urine of 608 anonymous women who had arrived at hospitals in Southern Denmark for a routine ultrasound scan.

Many of the women tested positive for cannabis, opiates, benzodiazepines, amphetamines, methamphetamine, cocaine, or methadone.

Forty-two of the women tested (representing 6.9 per cent of the total) had traces of drugs or addictive medicines in their urine. Of these, thirty-three tested positive for highly addictive opiates, which are typically found in heroin, codeine, and morphine and can cause withdrawal symptoms.

Four of the women tested positive for cannabis, two for benzodiazepines, which are found in anti-anxiety medication and sleeping pills. Two urine samples contained amphetamines and one contained methamphetamine.

“The screening doesn’t give an accurate answer as to how many pregnant women in Denmark take drugs or addictive medicines. But it gives us an indication," says Ibsen.

The results are published in the scientific journal Obstetricia a Gynecologica Scandinavica.

Uncertain how drugs damage the foetus

There is little research on the potential side effects that drug use during pregnancy might inflict upon the unborn foetus.

Scientists know that excessive alcohol consumption during pregnancy can lead to foetal alcohol syndrome--a congenital condition in which the child develops unusual facial features, and suffers growth retardation and brain damage.

Some drugs can lead to severe withdrawal symptoms and deformities in new-borns, but the area is still relatively unexplored. For one, it is difficult to research as scientists need to know how much and what drugs the mother took while she was pregnant, and then follow the child's development to see any harmful effects.

But even with this data, it is difficult to conclude anything concrete as the side effects may have been caused by any number of other reasons and are not necessarily due to drug use.

"It’s hard to identify what damage is caused when mothers take drugs whilst pregnant. At Family clinics, we see children with a variety of diffuse symptoms such as poor growth, behavioural problems, and emotional disorders. But we don’t always know which of these symptoms were caused by the mother’s drug use," says Ibsen.

"The symptoms can also be caused by poor nutrition, by smoking whilst pregnant, by taking a combination of medications, if the mother was subjected to violence, or if she was stressed. To find out how it all relates, you have to monitor the pregnant women at the time that they are using the drugs," she says.

Routine tests might do more harm than good

Ulrik Schiøler Kesmodel, a professor in gynaecology and obstetrics at Herlev and Gentofte University Hospital in Denmark, does not support the idea of a routine screening of pregnant women, which according to him, may do more harm than good.

"When screening a population such as pregnant women, there are a number of criteria that must be met. For example, you need to clearly identify the purpose of the screening and you must be sure that the screening method you use will provide results in a safe and accurate way,” says Kesmodel.

"You should also ensure that the test is socially and ethically acceptable to the users. These criteria aren’t met by the method used in this experiment,” he says.

Ibsen welcomes this criticism.

"We’re happy to get this kind of input, as we’d like to see the matter from different angles. It’s important to get contributions from others with knowledge and experience in the field," says Ibsen.

"The urine screening that we conducted was a pilot study to test the method and to see if we could get a number for how many people are using drugs,” she says.

“Our review of the literature on pregnant women and drugs has made us aware that the subject is not explored specifically well, so we’re working to find out how best we can investigate it. Urine Screening could be one of several ways we could do it," she says.

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Read the Danish version of this story on Videnskab.dk

 

Translated by: Catherine Jex

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