Research has consistently shown that women who abuse alcohol and other drugs late in their pregnancies have substantially elevated risks of premature delivery, which is associated with many other medical and developmental problems for their infants (see References 1-4). In part, the RWC/PPW program was intended to reduce such risks.

The cross-site study assembled pregnancy outcome information for 699 clients who were pregnant when they entered RWC/PPW and who later delivered while in treatment. It also collected pregnancy outcome information (specifically, infant mortality data) for 10,816 previous client pregnancies as part of the client admission questionnaire.

The findings were strikingly positive on all three major pregnancy outcome measures studied:

The rate of premature delivery among clients in treatment was 7.3%, representing a 70% risk reduction as compared to an expected 24.0% rate of premature deliveries among untreated alcohol or drug abusers (based on recent hospital-based studies);

Clients’ rate of low birth-weight delivery was 5.7%, an 84% risk reduction as compared to an expected 35.0% low birth-weight rate among untreated alcohol or drug abusers (also based on recent hospital-based studies); and

The infant mortality rate for clients’ infants was 0.4%, a 67% risk reduction as compared to the 1.2% infant mortality rate for previous client pregnancies – most of which presumably ended when clients were not in residential treatment.

These rates of adverse pregnancy outcomes are not only much lower than would be expected for untreated substance-abusing women, all three are also lower than the rates reported for all American women in US vital statistics (Exhibit 1 [also see Reference 5]).

The greatest RWC/PPW risk reduction was found for African-American women, who are at elevated risk of adverse outcomes in the general population. For example, African Americans in the general population have a 13.1% low birth-weight rate, as compared to 6.5% for whites, but African-American clients’ in-treatment low birth-weight rate was close to that for white clients (6.7% vs. 5.4%).

These findings suggest that residential treatment for pregnant women can have a substantial, positive effect in reducing risks of premature delivery and other adverse pregnancy outcomes. Although the cross-site study was not designed to identify the specific treatment factors that produce these results, beneficial treatment factors such as supervised alcohol and drug abstinence, improved prenatal care, improved nutrition, and reduced stress are likely causes.