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Drugs: Babies

Volume 474: debated on Thursday 3 April 2008

To ask the Secretary of State for Health how many children were born with drug-dependency problems in each of the last five years, broken down by (a) region and (b) type of drug. (195451)

The following tables show the number of finished consultant episodes (FCEs) where the primary or secondary diagnosis was either neonatal withdrawal symptoms from maternal use of drugs addiction or withdrawal symptoms from therapeutic use of drugs in newborn. Information is provided for the years 2002-03 to 2006-07, which is the latest data available, broken down by strategic health authority (SHA) of residence. It is not possible to provide information for what type of drug a newborn baby is addicted to.

Count of cases (FCEs) with a primary or secondary diagnosis of neonatal withdrawal symptoms from maternal use of drugs by SHA of residence for the period 2006-07

SHA of Residence

Total finished consultant birth episodes

North East SHA

52

North West SHA

100

Yorkshire and The Humber SHA

163

East Midlands SHA

64

West Midlands SHA

82

East of England SHA

95

London SHA

66

South East Coast SHA

40

South Central SHA

20

South West SHA

60

Other and unknown

469

Total

1,211

Count of cases (finished consultant birth episodes) with a primary or secondary diagnosis of neonatal withdrawal symptoms from maternal use of drugs by SHA of residence for the period 2002-03 to 2005-06

Total finished consultant birth episodes

SHA of Residence

2005-06

2004-05

2003-04

2002-03

Norfolk, Suffolk and Cambridgeshire SHA

*

*

*

*

Bedfordshire and Hertfordshire SHA

12

16

10

0

Essex SHA

0

8

*

*

North West London SHA

11

11

11

8

North Central London SHA

12

13

*

*

North East London SHA

*

0

*

0

South East London SHA

*

*

*

8

South West London SHA

*

0

*

0

Northumberland, Tyne and Wear SHA

6

*

*

*

County Durham and Tees Valley SHA

17

30

40

28

North & East Yorkshire and Northern Lincolnshire SHA

23

27

45

45

West Yorkshire SHA

13

11

27

17

Cumbria and Lancashire SHA

7

13

16

33

Greater Manchester SHA

10

8

11

39

Cheshire and Merseyside SHA

54

63

40

38

Thames Valley SHA

7

*

*

*

Hampshire and Isle of Wight SHA

*

9

7

*

Kent and Medway SHA

0

*

*

*

Surrey and Sussex SHA

13

11

13

18

Avon, Gloucestershire and Wiltshire SHA

62

40

44

51

South West Peninsula SHA

17

17

10

16

Dorset and Somerset SHA

28

8

9

12

South Yorkshire SHA

*

*

*

*

Trent SHA

6

8

10

8

Leicestershire, Northamptonshire and Rutland SHA

21

*

0

0

Shropshire and Staffordshire SHA

13

6

12

*

Birmingham and the Black Country SHA

*

*

*

*

West Midlands South SHA

*

0

6

11

Other and Unknown

860

873

817

694

Total

1,211

1,193

1,156

1,054

Notes:

1. Coverage and data quality:

The maternity tail data coverage is not as complete as the rest of HES data. There are a number of reasons for the coverage and data quality issues such as:

trusts submitting a significantly higher number of delivery episodes compared to birth episodes;

trusts failing to submit data on the number of birth episodes where they record a high number of delivery episodes;

trusts failing to submit delivery - the reason for this is that approximately 20 trusts have a stand alone maternity system which is not linked to the Patient Administration System;

trusts identifying a high number of maternity beds available, but not recording any information about deliveries or births;

trusts identifying that they have no maternity beds available, but recording a high number of birth and delivery episodes; and

Some trusts have space in their maternity system to record nine birth tails, whereas other systems have space for 18. As deliveries, miscarriages and abortions are all recorded in the birth tail, there are cases where nine tails is not enough to record all of the relevant data.

2. Between 2001-02 and 2005-06, coverage of hospital deliveries was 72.6 per cent., on average, whereas that of home deliveries was 13.6 per cent., on average. The incomplete coverage problem is significantly compounded by the data quality issues outlined.

3. Assessing growth through time:

HES figures are available from 1989-90 onwards. During the years that these records have been collected the NHS there have been ongoing improvements in quality and coverage. These improvements in information submitted by the NHS have been particularly marked in the earlier years and need to be borne in mind when analysing time series.

Some of the increase in figures for later years (particularly 2006-07 onwards) may be due to the improvement in the coverage of independent sector activity.

Changes in NHS practice also need to be borne in mind when analysing time series. For example a number of procedures may now be undertaken in outpatient settings and may no longer be accounted in the HES data. This may account for any reductions in activity over time.

4. FCE:

A FCE is defined as a period of admitted patient care under one consultant within one health care provider. The figures do not represent the number of patients, as a person may have more than one episode of care within the year.

5. All Diagnoses count of episodes:

These figures represent a count of all FCE’s where the diagnosis was mentioned in any of the 14 (seven prior to 2002-03) diagnosis fields in a HES record.

International Classification of Diseases (ICD)-IO diagnosis codes used:

P96.1 Neonatal withdrawal symptoms form maternal use of drugs of addiction.

P96.2 Withdrawal symptoms form therapeutic use of drugs in newborn.

6. Low Numbers:

Due to reasons of confidentiality, figures between one and five have been suppressed and replaced with ‘*’ (an asterisk).

7. Ungrossed Data:

Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed).

Source:

Hospital Episode Statistics (HES), The Information Centre for health and social care.

To ask the Secretary of State for Health how many children were born to drug-dependent mothers in each of the last five years, broken down by (a) region and (b) type of drug. (195452)

The following tables show the number of deliveries finished consultant episodes (FCEs) by drug dependent mothers by strategic health authority (SHA) region in 2002-03 to 2005-06, and in 2006-07; and the number of deliveries (FCEs) to drug dependent mothers for the same period, broken down by diagnosis code and type of drug used.

Count of deliveries by drug dependent mothers broken down by SHA of residence, 2002-03 to 2005-06

Total finished consultant delivery episodes

SHA of residence

2005-06

2004-05

2003-04

2002-03

Norfolk, Suffolk and Cambridgeshire SHA

489

362

410

360

Bedfordshire and Hertfordshire SHA

*

*

*

*

Essex SHA

11

37

11

7

North West London SHA

10

15

110

6

North Central London SHA

40

25

11

12

North East London SHA

18

7

6

19

South East London SHA

16

10

21

42

South West London SHA

12

10

12

6

Northumberland, Tyne and Wear SHA

66

55

44

22

County Durham and Tees Valley SHA

162

77

52

28

North and East Yorkshire and Northern Lincolnshire SHA

31

22

24

12

West Yorkshire SHA

45

33

47

39

Cumbria and Lancashire SHA

126

233

69

42

Greater Manchester SHA

110

92

80

22

Cheshire and Merseyside SHA

105

111

65

60

Thames Valley SHA

16

19

14

11

Hampshire and Isle of Wight SHA

10

10

8

*

Kent and Medway SHA

21

27

21

35

Surrey and Sussex SHA

43

33

34

24

Avon, Gloucestershire and Wiltshire SHA

38

40

36

27

South West Peninsula SHA

20

16

16

9

Dorset and Somerset SHA

*

8

6

12

South Yorkshire SHA

126

114

78

60

Trent SHA

122

105

93

80

Leicestershire, Northamptonshire and Rutland SHA

26

34

40

21

Shropshire and Staffordshire SHA

65

59

43

30

Birmingham and the Black Country SHA

167

138

81

45

West Midlands South SHA

38

33

19

8

Other and Unknown

17

13

6

15

Total

1,956

1,741

1,460

1,057

2006-07

SHA of residence

Total finished consultant delivery episodes

North East SHA

267

North West SHA

305

Yorkshire and the Humber SHA

227

East Midlands SHA

160

West Midlands SHA

287

East of England SHA

506

London SHA

58

South East Coast SHA

51

South Central SHA

23

South West SHA

64

Other and Unknown

22

Total

1,970

Count of deliveries by drug dependent mothers for the period 2002-03 to 2006-07 by diagnosis code and type of drug usedTotal finished consultant delivery episodesDiagnosis codeType of drug2006-072005-062004-052003-042002-03F10.2Alcohol8262503122F11.2Opioids1,0591,014946772535F12.2Cannabinoids10093815219F13.2Sedatives or hypnotics*812**F14.2Cocaine3247323325F15.2Other stimulants including Caffeine2710911*F16.2Hallucinogens16138814F17.2Tobacco641748606564440F18.2Volatile solvents*00*0F19.2Multiple drug use6132412718Total11,9701,9561,7411,4601,0571 For all years the total number of cases is higher when looking at the yearly total broken down by drug use compared to the yearly figure broken down by region. This is because there will be several cases where the mother has been diagnosed as using more than one type of drug and those drugs have been recognised. International Classification of Diseases-10 diagnosis code F19.2 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances is only used when patterns of psychoactive substance-taking are chaotic and indiscriminate or when the contributions of different psychoactive substances are inextricably mixed.Coverage and data quality:The maternity tail data coverage is not as complete as the rest of HES data. There are a number of reasons for the coverage and data quality issues such as:trusts submitting a significantly higher number of delivery episodes compared to birth episodes;trusts failing to submit data on the number of birth episodes where they record a high number of delivery episodes;trusts failing to submit delivery—the reason for this is that approximately 20 trusts have a stand alone maternity system which is not linked to the Patient Administration System;trusts identifying a high number of maternity beds available, but not recording any information about deliveries or births;trusts identifying that they have no maternity beds available, but recording a high number of birth and delivery episodes; andsome trusts have space in their maternity system to record nine birth tails, whereas other systems have space for 18. As deliveries, miscarriages and abortions are all recorded in the birth tail, there are cases where nine tails is not enough to record all of the relevant data.Between 2001-02 and 2005-06, coverage of hospital deliveries was 72.6 per cent. on average, whereas that of home deliveries was 13.6 per cent. on average. The incomplete coverage problem is significantly compounded by the data quality issues outlined above.Assessing growth through time:HES figures are available from 1989-90 onwards. During the years that these records have been collected the NHS there have been ongoing improvements in quality and coverage. These improvements in information submitted by the NHS have been particularly marked in the earlier years and need to be borne in mind when analysing time series.Some of the increase in figures for later years (particularly 2006-07 onwards) may be due to the improvement in the coverage of independent sector activity.Changes in NHS practice also need to be borne in mind when analysing time series. For example a number of procedures may now be undertaken in out-patient settings and may no longer be accounted in the HES data. This may account for any reductions in activity over time.Finished Consultant Episode (FCE):A FCE is defined as a period of admitted patient care under one consultant within one healthcare provider. The figures do not represent the number of patients, as a person may have more than one episode of care within the year.Secondary Diagnoses:As well as the primary diagnosis, there are up to 13 (6 prior to 2002-03) secondary diagnosis fields in Hospital Episode Statistics (HES) that show other diagnoses relevant to the episode of care.ICD-10 code used:Z37. Outcome of delivery (must always been found in the first secondary position)All Diagnoses count of episodes:These figures represent a count of all FCE’s where the diagnosis was mentioned in any of the 14 secondary (seven prior to 2002-03) diagnosis fields in a HES record.ICD-10 diagnosis codes used (and must be accompanied by secondary diagnosis code):F10.2 Mental and behavioural disorders due to use of alcohol, dependence syndrome;F11.2 Mental and behavioural disorders due to use of opioids, dependence syndrome;F12.2 Mental and behavioural disorders due to use of cannabinoids, dependence syndrome;F13.2 Mental and behavioural disorders due to use of sedatives or hypnotics, dependence syndrome;F14.2 Mental and behavioural disorders due to use of cocaine, dependence syndrome; F15.2 Mental and behavioural disorders due to use of other stimulants, including caffeine, dependence syndrome;F16.2 Mental and behavioural disorders due to use of hallucinogens, dependence syndrome;F17.2 Mental and behavioural disorders due to use of tobacco, dependence syndrome;F18.2 Mental and behavioural disorders due to use of volatile solvents, dependence syndrome;andF19.2 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances, dependence syndrome.The codes indicate addiction to all types of drugs. For example F11.2 Mental and behavioural disorders due to use of Opioids, would include addiction to Heroin and also Opioids found in prescription drugs.Low Numbers:Due to reasons of confidentiality, figures between one and five have been suppressed and replaced with ‘*’ (an asterisk). Where it was possible to identify numbers from the total due to a single suppressed number in a row or column, an additional smallest number have been suppressed in order to protect patient confidentiality.Ungrossed Data:Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed).Source: Hospital Episode Statistics (HES), The Information Centre for Health and social care.