BMC Public Health 2007, 7:322 http://www.biomedcentral.com/1471-2458/7/322 The data were analysed using bivariate and multivariate techniques in the SPSS-program. The level of significance was set to p ≤ 0.05. that had cannabis as their preferred drug had in addition been using great amounts of alcohol or central stimulat- ing drugs like ecstasy or cocaine. The study protocol was assessed by the Regional Commit- tee for Medical Research Ethics and approved by the Nor- wegian Data Inspectorate. The study has been conducted in full accordance with the World Medical Association Declaration of Helsinki. Results From the diagnosis register at the local hospital we obtained valid data from the period 1994–2002 on the diagnosis neonatal cramps, cerebral irritation, cerebral depression, reaction on medication, neonatal abstinence syndrome and observation in new borns. During these years one pregnancy did not result in contact with the SCWC. The incidence of children that attended SCWC was 6.1 pr. 1000 births in the county of Vest-Agder (range 4.1–10.2). Many of the 102 pregnant drug abusers were referred to our clinic by general practitioners (30%). A lot of different initiatives in the community health and social system also contributed, with the substance abuse counselling services referring 25 women (25%), and social/child welfare refer- ring 12 women (12%). The level of education among the users was significantly lower than in the comparison group (See additional file 1). A large percentage had their income from community support. Forty-eight users (47%) had either hepatitis C or B, nine (9%) had both. Treatment for psychiatric disease like depression and anx- iety disorders were found in the histories of 36 users (35%), and six (6%) had been diagnosed with somatic diseases like epilepsy, chronic obstructive pulmonary dis- ease, or rheumatism. No user had tuberculosis or HIV. Seven (7%) were homeless. Fifty-two of the women (52%) had been in some sort of treatment for substance abuse and six (6%) were in an institution for treatment for substance abuse when they got pregnant. Of all the 89 pregnant women that gave birth, only four (4.5%) were unable to cope with the intervention at the SCWC. It was not discovered that one woman continued to use alcohol, one moved to another city where she con- tinued the substance abuse, and two were sentenced to treatment after the new amendment to the Act Relating to Social Services from 1996 [12] where pregnant women that abuse substances can be sentenced to residential treatment until the child is born. All the 59 pregnant women that were investigated more closely, had a considerable reduction in substance abuse during their pregnancies as established by urine tests and self reports (See additional file 2). Even the 14 percent A total of 16 women had older children when admitted to the SCWC for the current pregnancy (22 children were registered). Seven of them had custody of one child each. The children of nine mothers were in foster homes. Twenty-eight (48%) of the 59 women had had adverse sexual experiences, whereof 20 (34%) had experienced both sexual abuse as a child (<16 yrs) and rape as an adult. Twenty-two (37%) women had been convicted of a crime, and nine had served time in prison, mostly short term sen- tences lasting a few months. One had served a sentence of more than one year in prison. The women's mean age for starting substance abuse was 15 years (range 11–22). They had been using substances for an average of 10 years (range 2–22) before the current pregnancy. All women abused more than one substance. Of the eight women (14%) that gave cannabis as their pre- ferred drug, all misused alcohol or central stimulating substances as well (See additional file 2). By self report, five pregnant women (8%) had managed to stop all abuse before pregnancy. They were all known by the initiatives cooperating with the clinic and were referred to SCWC for necessary support. Thirty-six women (61%) agreed to provide supervised urine samples. For 9 women (15%) giving urine samples was not deemed to be necessary, as the user was living with her parents or was cohabitant/married to a man with no drug problems. Fourteen women (24%) refused to provide urine samples. There was a disagreement between the user and the SCWC concerning this, and in these cases there was a great suspicion of continuing substance abuse. Cannabis was the most commonly detected agent among those who tested positive. Seven users had several positive urine tests. Nine women (16%) also stopped smoking when realizing they were pregnant. In general, the part- ners of the clinic's users had even more serious substance problems than the pregnant woman, except for 15 (24%) men who did not abuse any illicit substances or alcohol. Thirty-one of the women (53%) had contact with the social welfare system during their pregnancy; 25 (42%) with the child welfare service, 26 (44%) with substance abuse counselling, and 29 (32%) with community health services or the hospital. The total number of initiatives in contact with each user is listed in Figure 1. Univariate analyses of a selection of socio-economic and health variables indicated that members of the short-term user group were less likely than the long-term users to drink alcohol or to smoke during their pregnancy. Still, the drug users were more likely to smoke and use alcohol Page 4 of 8 (page number not for citation purposes)