Data for pregnant women on the Big Island suggest about half of the island's 37,892 children under age 18 were exposed before birth to alcohol, tobacco and illicit drug use, researchers report.

The findings also indicate that of about 2,200 deliveries on the island each year, almost 1,100 infants are born exposed.

“;We have to find out why this is happening and what effect this is having, especially on children,”; said Dr. Ira Chasnoff, a pediatrics professor at the University of Illinois College of Medicine, in a telephone interview.

Chasnoff, who is conducting the Big Island project, is one of the country's leading researchers on drug use during pregnancy and the effects on newborn infants and children. The nonprofit organization is concerned with healthy development of children and families.

“;We know from other studies what happens to children (prenatally exposed to tobacco, alcohol and illicit drugs),”; said Chasnoff, who is also president of the Children's Research Triangle in Chicago. The results are behavioral or learning disorders that are often misdiagnosed and treated with inappropriate medications.

“;Research shows 60 percent of prenatally exposed children end up in jail,”; he said, adding that programs he developed for children in Chicago have significantly reduced that rate.

Projecting effects of the screening data on Big Island children, the report says: “;Providing intervention and treatment to even a small proportion of these children through the mental health, education, child welfare and juvenile justice systems may be a driving force in the escalating costs for children's behavioral health services that are being documented across the state.

“;In light of these costs, the need for prevention and earliest intervention becomes clear.”;

The federally funded project involves a comprehensive system of screening, assessment and brief intervention for pregnant women from some physicians and public health clinics, including private pay and Medicaid patients.

“;If we find a woman with a positive screen, right there in the prenatal care office, providers are trained to do brief intervention,”; said Chasnoff. “;It is very successful in motivating women to stop using and has been shown to significantly decrease rates of prematurity and small birth weight.”;

Their findings are reported in “;The First 1,000 Women; Perinatal Substance Use on the Hawaii Island.”;

A surprise, he said, was the 43.1 percent rate of cigarette smoking among native Hawaiian women.

Caucasian and native Hawaiian women had the highest rates of positive screens for substance use, with 60 percent prevalence for each group. Substances also were used by 48 percent of the pregnant Asian women, 30 percent of Filipino women and 53 percent of women of mixed race.

Loretta Fuddy, chief of the state Health Department's Family Health Services Division, said Chasnoff's figures are a little higher than the department has seen through its perinatal risk assessment survey.

She said the important thing about Chasnoff's work is that he provides a model for intervention by physicians to try to prevent adverse effects.

The Health Department has a perinatal network and provides funding to community health centers to screen high risk women for alcohol, smoking, illicit drug use and domestic violence, she said.

The agency also is working with the child welfare system to provide early intervention services for children under age 3, Fuddy said.

Jackie Berry, executive director of Healthy Mothers, Healthy Babies, said Chasnoff's report shows screening works. “;A significant percentage of women who are told about the effects of substance abuse on the fetus stop using whatever they're using. ... Unfortunately, 50 percent don't.”;