A Cost–Beneficial Perinatal Substance Abuse Program

METHODS: A retrospective cohort study was conducted of 49,261 women who had completed prenatal substance abuse screening questionnaires at obstetric clinics and who had undergone urine toxicology screening tests. Four study groups were compared: women screened and assessed positive and followed by Early Start (screenedassessed-followed, n 2,032), women screened and assessed positive without follow-up (screened-assessed, n 1,181), women screened positive only (screened-positive-only, n 149), women in the control group who screened negative (control, n 45,899). Costs associated with maternal health care (prenatal through 1 year postpartum), neonatal birth hospitalization care, and pediatric health care (through 1 year) were adjusted to 2009 dollars. Mean costs were calculated and adjusted for age, race, education, income, marital status, and amount of prenatal care.