Laurence Simmat-Durand

Grossesse et substances psychoactives : étude de prévalence de la consommation déclarée

OBJECTIVES Evaluate substance use (tobacco, alcohol, psychotropic drugs, illicit drugs) declared before and during pregnancy. PATIENTS AND METHODS Two hundred and forty-five pregnant women were interviewed through a self-administered and anonymous questionnaire as they were going to a prenatal consultation in a maternity hospital in the Parisian area. RESULTS Before pregnancy, 16.3% of women reported smoking and 10.2% carried on smoking during pregnancy. Altogether, 40.8% of women reported alcohol consumption before pregnancy; 25.3% of women had contact with alcohol during pregnancy; 4.5% reported tobacco and alcohol consumption during pregnancy. During the month preceding the study, the consumption of psychotropic drugs (hypnotics, antidepressants or sedatives) was reported by 3.7% of women and that of marijuana by 2.4%. Moreover, the marijuana consumers, who tend to drink alcohol more often, combine important social and familial difficulties and represent a high-risk group. CONCLUSION Tobacco and alcohol use in this study were lower than in any previously conducted French surveys. Methodological specificities and cultural factors might explain those results. However, this is the first study that asses substance use and marijuana use, in particular, by French pregnant women.

Buprenorphine and Pregnancy

The perinatal prognosis for drug-addicted pregnant women and their children is clearly improved by a specialized treatment of their addiction, of which an essential element is the prescription of a substitute along with the necessary medico-and psychosocial support, and by early supervision of the pregnancy (1–3). Even though the prescription of high doses of buprenorphine is, in principle, not approved in France during pregnancy, the small number of openings available in methadone centers and more liberal prescription rules for high-dose buprenorphine mean, in practice, that numerous pregnant, drug-addicted women are having their treatment substituted with high-dose buprenorphine.

Maternités précoces : profils sociodémographiques de 220 mères adolescentes en Seine-Saint-Denis

OBJECTIVE As part of teenage pregnancies, it is often found vulnerability and pregnancy follow-up of poorer quality. This investigation aims to establish profiles of young women and to assess what followed. METHODS A retrospective study (2007-2011) of 220 births to women aged 12 to 17. RESULTS The monitoring of these teenage pregnancies remains generally lower than France national averages, but significant differences are observed when one takes into account the socio-demographic factors. Three profiles appear: 66 teenagers (group A) reported a chaotic pregnancy monitoring, with a poorly enquired social, professional, familial situation. One hundred and two teenagers (group B) have a better follow-up but pregnancy is often unwanted with an unstable social situation. Finally, 52 teenagers (group C) have a rather good quality monitoring with a more assertive investment of pregnancy. CONCLUSION To consider the lives of these young women is essential to study early motherhood and mitigate the vulnerabilities of this fragile population. An identification of factors favoring an optimal monitoring of pregnancy among young women is paralleled with reduced obstetric and social risks.

Pregnancy Under Subutex (Buprenorphine): Opinions Expressed on French Internet Forums

Internet forums record the opinions and advice exchanged about pregnancy under Subutex. Two hundred and fourteen messages under 92 nicknames from four forums, especially dedicated to this subject in France, from August 2005 to July 2008 were collected and analyzed with QSR NIVIVO8. Most of the Internet users were women, pregnant, or with children, using Subutex. Very few professionals took part in them. The analysis of the opinions and representations of this substance, of medical practices, of exchanged advice, particularly on posology, was realized by the construction of a thematic tree.