Stony Brook researchers find unique way to screen pregnant women for substance abuse

A screening tool developed at Stony Brook University may help researchers identify women who may be at higher risk of using drugs while pregnant.

The study, which reviewed medical charts and was published in the Journal of Addiction Medicine in November, found that pregnant women in the research who had less education were more likely to use tobacco. Pregnant women who were single and without a partner in the research were more likely to use cannabis.

Researchers also found that women who identified as coping with a significant stressful life event were more likely to use alcohol during their pregnancy, the study found.

To obtain the results, university researchers examined the medical charts of approximately 1,840 patients who used the PROMOTE Prenatal Screener in their first prenatal care at an outpatient clinic in New York.

Overall, what they found was that nearly 10% of patients used at least one substance while pregnant, the university said. About 7% used tobacco, about 3% used cannabis, and about 2.5% used alcohol.

The results, researchers say, show that a well-proven screening tool provides insights into vulnerable patients and potentially opens a path to better well-being for both mother and baby.

“I think the most important finding is that screening for women’s social and psychological vulnerabilities and drug use can not only help identify and address their current needs but can also help address and identify women at risk for future drug abuse when they become pregnant and potentially prevent that type of use, said Heidi Preis, who led the study and is an assistant professor in the Department of Obstetrics, Gynecology and Reproductive Medicine at Stony Brook.

Preis said there are several different types of barriers to connecting vulnerable pregnant women with needed care and help, including sometimes the patient’s fear of being scrutinized. Also, she said, some doctors may feel uncomfortable bringing up the topics or may not have time to ask.

Although screening for depression is more common, comprehensive screening tools such as PROMOTE measure questions such as stress, social support and substance abuse are rare, she said. PROMOTE research in areas such as financial stability, living conditions, stress and mental health. It may take 2 to 3 minutes to complete or a few minutes longer for people who are asked more detailed questions about opioid use, the university said.

After receiving the results of the screening, a provider can speak with a patient to determine if any problem picked up in the screener is a genuine problem. From there, they can work with the patient to determine the next course of action, which could include smoking cessation or a food assistance program.

“So depending on what’s identified, then the providers have resources within Stony Brook and outside of Stony Brook to refer the patient,” she said.

Currently, PROMOTE is available to pregnant women at Stony Brook clinics. Researchers say they want to expand it to other institutions.

David Nemiroff, president and CEO of Harmony Healthcare Long Island, said the Federally Qualified Health Center uses other tools to identify patients in need, including one for social determinants of health and another for depression.

In general, Nemiroff said screening tools are an important way to help people who are reluctant to talk to a medical provider.

“Any tool that helps people identify a disease or a disease and can connect people to treatment for care, I don’t think is a bad thing,” he said.

Sherri Kaplan, vice president of Program Excellence at CN Guidance & Counseling Services, said the nonprofit also uses screening tools for substance abuse disorders.

However, the PROMOTE tool can be a prominent way to engage with pregnant women in a medical setting who are not necessarily seeking substance abuse treatment, she said.

“They go because they’re pregnant,” she said. “What a great way to try to engage them and start that conversation in a non-behavioral health clinic.”

“They catch them at a different time,” she added.