Psychosocial Res. to Improve Drug Treatment in Pregnancy

Summary

Principal Investigator: KIMBERLY A contact YONKERS
Abstract: [unreadable] DESCRIPTION (provided by applicant): [unreadable] Illicit and licit substance abuse by pregnant women is common and can lead to a number of deleterious effects in mother and her offspring. For example, risks of HIV for both mother and baby are elevated and the infant is more vulnerable to both structural defects and impaired neurodevelopment. Not only is hazardous substance use in pregnancy often undetected, but women with substance abuse and dependence frequently receive no treatment for their substance use and less than optimal amounts of prenatal care. Behavioral treatments, including motivational interviewing and relapse prevention for substance abuse, are effective for other substance abuse populations, including primary care patients. However, they have not been systematically tested in pregnant women who use cocaine, marijuana or methamphetamines. Behavioral treatments are ideal candidates to use in pregnant patients since they obviate the need for pharmacological interventions that carry their own risks of toxicity. Moreover, they can capitalize on constructive changes in health behaviors that often accompany pregnancy. Behavioral treatments delivered by the patient's obstetrical providers constitute an integrated approach that strengthens substance abuse treatment and prenatal care. In this application, we propose a randomized, controlled trial to evaluate a combined motivational and cognitive behavioral intervention for pregnant women with hazardous substance use. This trial takes advantage of the repeated prenatal visits a woman has with her clinician and provides a unique opportunity to deliver substance abuse treatment that is fully integrated with perinatal care. This would constitute the first systematic, randomized and controlled relapse prevention study to address cocaine, marijuana and other illicit substance abuse in pregnant women. We propose to: 1) conduct screening at two publicly funded perinatal clinics in Connecticut, the Yale New Haven Hospital Women's Center and the Bridgeport Hospital Prenatal Care Clinic; 2) enroll 260 women; 3) hold counseling sessions conjoint within prenatal visits; and 4) stratify for primary substance of abuse (marijuana, cocaine or alcohol). Outcomes for this study are the percentage of days the mother used any substances (primary), reduction in the HIV risk behaviors, (secondary) and assessment of fetal outcomes (secondary). [unreadable] [unreadable] [unreadable] [unreadable]
Funding Period: 2004-09-20 - 2010-08-31
more information: NIH RePORT

Top Publications

  1. pmc A treatment for substance abusing pregnant women
    Kimberly Ann Yonkers
    Perinatal Research Program, Department of Psychiatry, Yale University School of Medicine, 142 Temple Street, New Haven, CT 06510, USA
    Arch Womens Ment Health 12:221-7. 2009
  2. pmc Screening for prenatal substance use: development of the Substance Use Risk Profile-Pregnancy scale
    Kimberly A Yonkers
    Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
    Obstet Gynecol 116:827-33. 2010
  3. pmc Prenatal hazardous substance use and adverse birth outcomes
    Odayme Quesada
    Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
    J Matern Fetal Neonatal Med 25:1222-7. 2012
  4. pmc Motivational enhancement therapy coupled with cognitive behavioral therapy versus brief advice: a randomized trial for treatment of hazardous substance use in pregnancy and after delivery
    Kimberly A Yonkers
    Department of Psychiatry, the School of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06510, USA
    Gen Hosp Psychiatry 34:439-49. 2012
  5. pmc Perinatal smoking and depression in women with concurrent substance use
    Ariadna Forray
    Department of Psychiatry, Yale School of Medicine, USA Electronic address
    Addict Behav 39:749-56. 2014

Detail Information

Publications6

  1. pmc A treatment for substance abusing pregnant women
    Kimberly Ann Yonkers
    Perinatal Research Program, Department of Psychiatry, Yale University School of Medicine, 142 Temple Street, New Haven, CT 06510, USA
    Arch Womens Ment Health 12:221-7. 2009
    ..Treatment fidelity was assessed using the Yale Adherence and Competence System. Behavioral treatment delivery in this setting is feasible and is being evaluated in a randomized, controlled, clinical trial...
  2. pmc Screening for prenatal substance use: development of the Substance Use Risk Profile-Pregnancy scale
    Kimberly A Yonkers
    Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
    Obstet Gynecol 116:827-33. 2010
    ..To report on the development of a questionnaire to screen for hazardous substance use in pregnant women and to compare the performance of the questionnaire with other drug and alcohol measures...
  3. pmc Prenatal hazardous substance use and adverse birth outcomes
    Odayme Quesada
    Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
    J Matern Fetal Neonatal Med 25:1222-7. 2012
    ..Assess the relative effects of a variety of illicit and licit drugs on risk for adverse birth outcomes...
  4. pmc Motivational enhancement therapy coupled with cognitive behavioral therapy versus brief advice: a randomized trial for treatment of hazardous substance use in pregnancy and after delivery
    Kimberly A Yonkers
    Department of Psychiatry, the School of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06510, USA
    Gen Hosp Psychiatry 34:439-49. 2012
    ..The objective was to compare the efficacy of motivational enhancement therapy coupled with cognitive behavioral therapy (MET-CBT) to brief advice for treatment of substance use in pregnancy...
  5. pmc Perinatal smoking and depression in women with concurrent substance use
    Ariadna Forray
    Department of Psychiatry, Yale School of Medicine, USA Electronic address
    Addict Behav 39:749-56. 2014
    ..The purpose of this report was to examine the course of smoking among pregnant women with concurrent substance use, and to assess the impact of depression on smoking...