Examining the "cost" of substance abuse in pregnancy: patient outcomes and resource utilization.
OBJECTIVE: This study investigated the clinical and financial impact of self-reported maternal drug history and documented intrauterine substance exposure on maternal-neonatal morbidity and hospital costs. STUDY DESIGN: This two-part, case-controlled, retrospective study used matching control groups. RESULTS: Among women reporting a history of substance abuse during or prior to the index pregnancy, (a) maternal hospital costs were significantly higher and more variable; (b) birth weight, length, and gestational age were lower; (c) no significant differences were noted in the number of maternal risk factors or neonatal complications and hospital costs. In comparison of neonates with positive toxicology screens and a matched control group, there were no differences in neonatal outcomes or costs, but the number of complicating maternal risk factors and maternal hospital costs were significantly different. CONCLUSION: Knowledge of maternal substance abuse history may be useful in planning for maternal-neonatal care needs and reimbursement for hospital care for this at-risk patient population.