Drug-Baby Level Put at 2% in O.C.

About 2% of the children born in Orange County--about 80 babies a month--are exposed to cocaine, PCP or other illegal drugs while in the womb, according to a study released Wednesday.

Investigators who conducted the study said the rate of exposure is surprisingly low, noting that similar surveys in Pinellas County, Fla., New York City and Sacramento County have turned up exposure rates of 8% to 28%.

Nonetheless, health officials said the problem in Orange County is serious.

“It isn’t New York. It isn’t Miami. But if you extrapolate to all births, I’d calculate you could fill up one classroom a week with drug-affected babies,” warned Dr. Thomas J. Garite, a UC Irvine chief of obstetrics who was a principal investigator for the study.

The survey was conducted last October in maternity wards at 26 hospitals. Experts from UCI, the March of Dimes, the Orange County Health Care Agency and the Hospital Council of Southern California teamed up to produce the first countywide assessment of the drug-baby problem here. The results were announced at a meeting of the Orange County Perinatal Council.

During the survey’s one-week period, 700 of the 991 women who delivered babies were given confidential urine tests for drug and alcohol use. Hospital ethics committees approved a procedure in which the women were not told that they were being tested for drug use.

Initially, lawyers for the American Civil Liberties Union and the Poverty Law Center in Santa Ana objected to the testing and vowed to monitor the study.

But Garite said he was never contacted by the attorneys. And, he explained Wednesday, federal research guidelines allow testing on “unsuspecting subjects,” as long as lab specimens are discarded and “absolute confidentiality” is maintained. Though volunteer surveyors took some information from each woman’s medical chart, the only identifying data that accompanied her urine specimen was a code number and her ZIP code, Garite said.

Of samples collected from 700 women, 14 tested positive for illicit drugs, Garite reported. The tests showed four of their babies were exposed to marijuana, four to opiates, two to cocaine, one to methamphetamine and three to combinations of drugs (morphine and codeine; morphine, amphetamine and PCP; and cocaine and marijuana).

Exposure to drugs in pregnancy can have a wide range of effects, from addiction to birth defects to hyperactivity.

None of the babies in the study showed withdrawal symptoms, but some exhibited other problems, Garite said. Some had lower birth weights and lower Apgar scores (tests at birth assessing breathing, muscle tone and responsiveness) than babies not exposed to illegal drugs. Also, two had birth defects (a cleft palate in one baby, a defective abdominal wall in another).

Another 11 mothers--1.6%--tested positive for alcohol use but since none of their babies showed problems at birth, Garite speculated the mothers may have had a beer or a glass of wine to relax when labor began, rather than consumed alcohol regularly during pregnancy.

Garite cited three reasons why Orange County’s rate of drug-exposed babies was significantly lower than elsewhere.

The county’s affluence may contribute to a low maternal substance abuse rate, he suggested. “It’s probable that people with high incomes tend to use drugs less,” he said.

Another factor: Latino babies accounted for 43% of births but only 14% of drug-using mothers. “Our Hispanics clearly use drugs less than any other population group,” Garite said. “Our Hispanics are first generation and less acculturated than, perhaps, people in East Los Angeles, with less gangs, less drugs.”

Also, Garite and Dr. Lynn Hunt, a UCI pediatrician who operates a clinic for drug-exposed children, wondered if the week of the survey may have been a quiet week for drug babies. “The survey reported three cocaine-positive babies,” she noted “but this past week we’ve had seven cocaine-positive babies” at UCI Medical Center.

The drug prevalance study indicates that doctors and nurses are not recognizing drug-exposed babies. About 4,000 babies are born each month in Orange County, and at a rate of 2%, 80 of them are probably exposed to drugs. But only about 30 Orange County newborns are reported each month to public health officials as drug-affected, he said. Only five of 14 drug-exposed babies detected in the survey were reported to public health officials.

“We’re missing the majority,” said Garite, and eventually “they’ll have an impact on school systems, social service agencies, prisons.”

The study found reasons for the underreporting. It showed that hospitals are often not testing a mother-to-be for drug use, even when standard criteria indicate that such a test is warranted, Garite said. Also, he said, sometimes the drug-exposed criteria don’t work; of the 14 drug-using mothers, nine “would not have been picked up by standard tools,” so better tests are needed.

Dottie Andrews, community affairs director for the March ofDimes, said she hoped the survey would give added impetus to her agency’s educational programs, including a high school lecture program called “Drug Babies Don’t Need to Be.”

“To jump to the conclusion that we don’t have a problem would be a mistake,” Andrews said. “We have to keep pushing to do what we’re doing--and push for residential treatment” of pregnant women. “We have a chance to see 2% go to 1/2%--or zero percent.”