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Severity of drug use, initiation of prenatal care, and maternal-fetal attachment in pregnant marijuana and cocaine/heroin users.

OBJECTIVE
To compare the severity of drug use, initiation of prenatal care, and maternal-fetal attachment between pregnant marijuana and cocaine/heroin users.


DESIGN
A cross-sectional design.


SETTING
A prenatal clinic of a medical center in the northeast of the United States.


PARTICIPANTS
19 marijuana, 17 cocaine, and 4 heroin users. Cocaine and heroin users were combined in one group.


MAIN OUTCOME MEASURES
The Severity of Drug Use Questionnaire containing 11 questions of withdrawal, dependence, and medical, legal, and interpersonal issues was used to assess the severity of drug use. Initiation of prenatal care was obtained from the chart and was calculated by weeks of gestation when care began. Cranley's Maternal-Fetal Attachment Scale measured maternal-fetal attachment.


RESULTS
Pregnant cocaine/heroin users were 6 years older, had experienced more pregnancies, had higher drug severity scores, and initiated prenatal care later than marijuana users. No significant difference in maternal-fetal attachment was found.


CONCLUSION
Interventions to help especially cocaine/heroin users initiate early prenatal care and reduce severity of drug use are indicated.