Perinatal Illicit Drug and Marijuana Use: An Observational Study Examining Prevalence, Screening, and Disclosure.

Abstract Purpose. To assess use, screening, and disclosure of perinatal marijuana and other illicit drugs during first obstetric visits. Design. Observational study that qualitatively assesses provider screening and patient disclosure of substance use. Setting. Study sites were five urban outpatient prenatal clinics and practices located in Pittsburgh, Pennsylvania. Participants. Pregnant patients and obstetric providers were recruited as participants. Methods. We audio recorded patient-provider conversations during first obstetric visits and obtained patient urine samples for drug analyses. Audio recordings were reviewed for provider screening and patient disclosure of illicit drug use. Urine analyses were compared with audio recordings to determine disclosure. Results. Four hundred and twenty-two pregnant patients provided complete audio recordings and urine samples for analyses. Providers asked about illicit drug use in 81% of the visits. One hundred twenty-three patients (29%) disclosed any current or...