MANY BIG ISLE KIDS HAD PRENATAL SUBSTANCE EXPOSURE

Data for pregnant women on the Big Island suggest about half of the
island's 37,892 children under age 18 were exposed before birth to
alcohol, tobacco and illicit drug use, researchers report.

The findings also indicate that of about 2,200 deliveries on the
island each year, almost 1,100 infants are born exposed.

"We have to find out why this is happening and what effect this is
having, especially on children," said Dr. Ira Chasnoff, a pediatrics
professor at the University of Illinois College of Medicine, in a
telephone interview.

Chasnoff, who is conducting the Big Island project, is one of the
country's leading researchers on drug use during pregnancy and the
effects on newborn infants and children. The nonprofit organization
is concerned with healthy development of children and families.

"We know from other studies what happens to children (prenatally
exposed to tobacco, alcohol and illicit drugs)," said Chasnoff, who
is also president of the Children's Research Triangle in Chicago. The
results are behavioral or learning disorders that are often
misdiagnosed and treated with inappropriate medications.

"Research shows 60 percent of prenatally exposed children end up in
jail," he said, adding that programs he developed for children in
Chicago have significantly reduced that rate.

Projecting effects of the screening data on Big Island children, the
report says: "Providing intervention and treatment to even a small
proportion of these children through the mental health, education,
child welfare and juvenile justice systems may be a driving force in
the escalating costs for children's behavioral health services that
are being documented across the state.

"In light of these costs, the need for prevention and earliest
intervention becomes clear."

The federally funded project involves a comprehensive system of
screening, assessment and brief intervention for pregnant women from
some physicians and public health clinics, including private pay and
Medicaid patients.

"If we find a woman with a positive screen, right there in the
prenatal care office, providers are trained to do brief
intervention," said Chasnoff. "It is very successful in motivating
women to stop using and has been shown to significantly decrease
rates of prematurity and small birth weight."

Their findings are reported in "The First 1,000 Women; Perinatal
Substance Use on the Hawaii Island."

A surprise, he said, was the 43.1 percent rate of cigarette smoking
among native Hawaiian women.

Caucasian and native Hawaiian women had the highest rates of positive
screens for substance use, with 60 percent prevalence for each group.
Substances also were used by 48 percent of the pregnant Asian women,
30 percent of Filipino women and 53 percent of women of mixed race.

Loretta Fuddy, chief of the state Health Department's Family Health
Services Division, said Chasnoff's figures are a little higher than
the department has seen through its perinatal risk assessment survey.

She said the important thing about Chasnoff's work is that he
provides a model for intervention by physicians to try to prevent
adverse effects.

The Health Department has a perinatal network and provides funding to
community health centers to screen high risk women for alcohol,
smoking, illicit drug use and domestic violence, she said.

The agency also is working with the child welfare system to provide
early intervention services for children under age 3, Fuddy said.

Jackie Berry, executive director of Healthy Mothers, Healthy Babies,
said Chasnoff's report shows screening works. "A significant
percentage of women who are told about the effects of substance abuse
on the fetus stop using whatever they're using. ... Unfortunately, 50
percent don't."

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ABUSIVE BEHAVIOR

Results of the first 1,000 pregnant women on the Big Island screened
for alcohol, tobacco and illicit drug use:

The rate of cigarette smoking among native Hawaiian women was 43.1
percent, and 64.6 percent continued smoking after learning they were pregnant.

Native Hawaiian women had the highest rates of smoking and Caucasian
women the highest rates of alcohol and marijuana use in the month
before they knew they were pregnant.

All groups tended to stop substance use after learning they were
pregnant, but 64.6 percent of Hawaiian women continued to smoke and
45 percent of Caucasian women continued to drink alcohol.

Source: "The First 1,000 Women; Perinatal Substance Use on Hawaii Island"