B3 Pregnancy and neonatal discharges
Key Points 2004/05
Overview
Note that a greater number of births than maternities can be recorded as multiple births are recorded as only one maternity.
- In 2004/05 there were 493 maternities for which drug misuse was recorded, a rate of 9.4 per 1,000 maternities (Table B3.1).
- Nearly three-quarters (74%) of maternities recording drug misuse were for mothers aged under 30 years. For all maternities just over half (51%) are mothers aged under 30 years (Table B3.1).
- Of the 497 births recording drug misuse 69% were recorded as full-term normal birthweight (341). For all births 90% were recorded as full-term normal birthweight (47,466). 18% of the births recording drug misuse were preterm (90) compared to 8% of all births (4,167) (Table B3.4).
- The majority of births recording drug misuse, 51% (252), were recorded as being in the fifth deprivation category (most deprived). For all births 24% (12,517) were recorded as being in the most deprived category. The rate of births recording drug misuse per 1,000 births increased from 1.3 per 1,000 births in the least deprived category (category 1) through to 20.1 per 1,000 births in the most deprived category (category 5) (Table B3.5).
- 300 neonatal discharges recorded drug misuse, 5.7 per 1,000 live births. It should be noted that neonatal discharge information is only recorded for babies who require medical care, or who have a congenital anomaly (Table B3.6).
Five year trends — 2000/01 to 2004/05
- The number of maternities recording drug misuse increased over period 2000/01 to 2004/05, from 237 to 493 (Table B3.1).
- The rate of maternities recording drug misuse per 1,000 maternities showed a similar pattern, rising from
- 4.6 per 1,000 maternities in 2000/01 to 9.4 per 1,000 maternities in 2004/05 (Table B3.1).
- The proportion of maternities recording drug misuse which recorded opioid use has increased between 2000/01 and 2004/05, from 54% (127) of maternities to 68% (336) of maternities (Table B3.2).
Drugs recorded
- Opioids were recorded in 68% (336) of the maternities for which drug misuse was recorded. Other drugs recorded were cannabinoids in 21% (104) and sedatives in 14% (70) (Table B3.2).
Background information
Data on individual patients are collected by ISD Scotland as a series of Scottish Morbidity Records (SMR).
The SMR datasets are a significant local and national information resource, and are used for epidemiological monitoring, health needs assessment, national and local planning and a range of other applications.
Pregnancy
Since 1976 data has been collected on pregnancies relating to antenatal, delivery, postnatal care and abortions managed in Scottish hospitals on the SMR02 (Scottish Morbidity Record -Maternity Discharges). Deliveries account for more than half of SMR02 discharges each year (antenatal, postnatal and abortion episodes make up the remaining discharges) and a national coverage of up to 98% of all births has been achieved (some home births may not be included).
The SMR02 discharge summary is completed at the end of the episode from patient’s case notes and hospital discharge letters. Information collected includes: demographics of the mother, details of the delivery (mode, induction, presentation etc) and on the baby (gestation, birth-weight, etc). Details of up to and including three babies are recorded. In addition up to six diagnoses, a main diagnosis and five secondary diagnoses (using the ICD10 coding classification) can also be recorded. Specific questions are asked about the mother smoking prior to and during pregnancy. Drugs misuse is recorded on the SMR02 using the following ICD10 codes:
ICD10 |
Description |
F11 |
Opiods |
F12 |
Cannabinoids |
F13 |
Sedatives or Hypnotics |
F14 |
Cocaine |
F15 |
Other Stimulants |
F16 |
Hallucinogens |
F18 |
Volatile Solvents |
F19 |
Multiple / Other Psychoactive Substances |
O35.5 |
Maternal care for suspected damage to fetus by drugs |
Additionally drug misuse can be recorded as a hard-coded data item, which was introduced in April 2003. However, not all hospitals are able to submit using the hard-coded data item, as their patient administration system (PAS) has not been modified to allow this.
Neonatal discharges
Neonatal discharges were originally recorded using SMR11 records (including from neonatal units and postnatal cots), with records being generated for sick babies who fall into one of the following categories:
- Babies who require medical care (other than resuscitation immediately after birth or routine screening).
- Babies who have a congenital anomaly (whether or not medical treatment is given at that time).
The SMR11, which was completed only for sick babies admitted to neonatal units, was replaced by the Scottish Birth Record (SBR) from April 2003. The SBR has been incrementally implemented across Scotland from 2003, with all areas (except Inverclyde) now using SBR to record information for sick babies, and the majority of areas now recording information on all births.
Drugs misuse is recorded on the SMR11 and the SBR returns using the following ICD10 codes in addition to those listed for SMR02.
ICD10 |
Description |
P04.4 |
Fetus and newborn affected by maternal use of drugs of addiction |
P96.1 |
Neonatal withdrawal symptoms from maternal use of drug addiction |
The figures presented here cover the five years, 2000/01 to 2004/05. Data for all years shown are revised, so may be different from previously published figures. Care should be taken when comparing numbers over time, as there has been an improvement in drug misuse recording over the last five years. However, it is also worth noting that recording practice of drug misuse diagnoses may vary between hospitals, which may explain some of the variation between NHS boards or council areas. The replacement of SMR11 with the SBR, which occurred incrementally across Scotland may also have had an impact on these figures.
Further information
Information on ISD Scotland’s national datasets can be found on our website at: http://www.isdscotland.org/what_data_are_collected
Information on the background of the Scottish Birth Record and current development is available at: http://www.sbr.scot.nhs.uk/
Further statistics relating to births are available at: http://www.isdscotland.org/births
If you would like further information relating to drug misuse and pregnancy or neo-natal care then please contact the Substance Misuse Information Strategy Team at substancemisuse@isd.csa.scot.nhs.uk.
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