BMC Public Health 2007, 7:322 http://www.biomedcentral.com/1471-2458/7/322 than the comparison group. More short-term users than long-term users had never been in treatment for substance abuse, and they also had a higher likelihood of having been the victim of rape as an adult. At the same time, fewer in the short-term group received economical sup- port from the community. Both substance abuse in the immediate family and sexual abuse in childhood were more frequent in the user group than in the comparison group. Additional socio-economical and health data are listed in additional file 3. In a multivariate logistic regression analysis with short/ long term drug abuse in pregnancy as a dependent varia- ble, we found that to quit smoking and to be a victim of rape were characteristics significantly associated with stopping drug abuse before the end of the first trimester (See additional file 4). Discussion The main findings in this study are that most of the referred women with substance abuse problems that con- tinued the pregnancy were able to follow a treatment plan at the SCWC, and that we observed a reduction in sub- stance abuse during pregnancy. Extensive collaboration with other services within the community and health sys- tem, and home visits if appointments were not kept, con- tributed to us being able to provide a treatment adjusted for individual needs. This is in agreement with what oth- ers have found to be important for pregnant substance abusing women [13-17]. All the users did reduce their abuse of substances during pregnancy as measured by self report and urine tests. The reduction often started before attending the SCWC, which is also consistent with what others have found [18]. Studies have also shown that if pregnant substance abusing women do not attend prena- tal care, there is a tendency to continue substance abuse during pregnancy [19]. The group that had experienced rape was significantly more frequent in the group of short-term substance abus- ers, with an odds ratio of 5.3. Sexual abuse and rape was an important issue to consider when preparing for deliv- ery. Studies have shown that incest survivors might have problems with parenting [20,21]. However, we found no difference in substance abuse during pregnancy among the sexually abused when compared to women without this adverse experience. The pregnancy might be consid- ered as an opportunity to reconstruct a family for women that have abusive partners [22]. As problems resulting from sexual victimisation and the woman's relationship with her partner are important issues when preparing for delivery, it is possible that the intervention at the SCWC had a significant influence on the woman's substance abuse during her pregnancy. We also found that more women in the short-term group than in the long-term group had previously never been in treatment for their substance abuse, although this differ- ence did not reach significance. Those who had not been in treatment were also significantly younger (p = 0.007) than the group that had been in treatment, and there was a tendency that the pregnant women that had been sub- stance abusers for a short time only, were better able to change their behaviour during pregnancy. The percentage that stopped using alcohol or tobacco in pregnancy was higher in the short-term group of sub- stance abusers, however compared to the comparison group they smoked and used alcohol more frequently. This finding is supported by other, previous studies [23]. The odds ratio for short-term substance abuse in preg- nancy was 9.7 times higher in the group that did not smoke or stopped smoking immediately when they found out they were pregnant. Substance abuse in the immediate family and sexual abuse in childhood was found more often in the drug user group than in the comparison group, which is also what is described by others [24]. As observed in other studies [25], the education level among the substance abusing women was generally low; 88 percent had not finished upper secondary education. The level of education was lower than in the comparison group. Forty-eight percent of the clinic's users were unem- ployed or in some community supported activity receiv- ing financial support from social security benefits at the time they got pregnant. Commonly, the housing situation for the women was not of a standard where it was possible to raise a child. The group of homeless persons is smaller than found in other studies in Europe [26], but these stud- ies mostly include men. Studies on substance in Scandina- via indicates that the number of homeless people are lower [27]. Among the women that continued the pregnancy, 29 (48%) were positive for hepatitis C or B. This corresponds well with reports for substance abusers from other cities in Europe [26,28]. In this investigation we have not distin- guished between intravenous and non intravenous sub- stance abuse, as both can harm the baby before birth and both may destroy the mother-child relationship. We found that 36 users (35%) had some psychiatric dis- order, which is a little lower than reported by others [21,29]. Most studies on psychiatric co-morbidity are from different treatment programs for substance related problems. In our material 52 women (66%) had been in treatment before the pregnancy. The strength of this study is that we have studied a group of substance abusing, pregnant women in a low-threshold Page 5 of 8 (page number not for citation purposes)