Mode of Delivery in Drug-Dependent Pregnant Women: A Case Control Study

Abstract EN

Objective.

To determine the contribution of drug use during pregnancy to the route of delivery.

Methods.

A case-control study was conducted at a hospital in Coimbra, Portugal, between 2001 and 2014.

Drug-dependent pregnant women (n=236) were compared with a control group of low risk women (n=228) in terms of maternal characteristics, obstetric history, pregnancy complications, and labor details.

Factors that influenced the mode of delivery were determined.

Statistical analysis was performed with SPSS v.

23.0 (IBM Corp.).

p values < 0.05 were considered statistically significant.

Results.

Drug-dependent women presented a lower rate of cesarean delivery (18.2 versus 28.9%, p=0.006).

After adjusting for the factors that were significantly related to the mode of delivery, drug dependency influenced the rate of cesarean section (β=0.567; 95% CI = 0.328–0.980).

Within the drug-dependent group, the mode of delivery was significantly related to previous cesarean or vaginal delivery (p=0.008 and p<0.001, resp.) and fetal presentation (p<0.001), but not with the type of drug, route of administration, or substitution maintenance therapy.

Conclusions.

The drug-dependent group presented a significantly higher rate of vaginal delivery.

However, this was not associated with the behavioral factors analyzed.

We hypothesize that other social and psychological factors might explain this difference.