CHARLESTON — Nearly one-fifth of babies in West Virginia are born to mothers who used drugs or alcohol while pregnant, a new study shows — evidence of a problem far worse than previous research has revealed.

Marijuana, opiates and alcohol topped the list of substances used by pregnant women, whose babies’ umbilical cord tissues were analyzed for the Marshall University study.

Overall, 19 percent of the babies were exposed to drugs or alcohol during pregnancy.

Researchers found evidence of marijuana use in 7 percent of the samples. Five percent of the samples tested positive for alcohol. Five percent tested positive for opiates, which include prescription painkillers.

Many of the mothers had used multiple drugs.

But the seemingly startling numbers don’t shock the people who take care of drug-addicted mothers and babies. They say they have seen a crisis unfolding in West Virginia delivery rooms for a decade.

“I wasn’t surprised because I’ve been on the front lines,” said Marshall University obstetrician David Chaffin, who conducted the study with other doctors. “We’ve seen a tremendous increase in the number of mothers who are on drugs.”

Dr. Chaffin has seen babies “zonked out on Valium” — sleepy, weak and struggling to breathe. He has seen babies vomit and cry as they suffer from opiate withdrawal.

Medical literature indicates that between 10 percent and 14 percent of babies nationally are exposed to drugs and alcohol in the womb, Chaffin said. But other studies have used different methods to gauge the problem, so experts can’t compare them.

A mother’s addiction can plague a child long after birth, said Nancy Tolliver, director of the West Virginia Perinatal Partnership. Alcohol abuse during pregnancy is a leading cause of mental retardation.

“We know that even if they don’t have obvious symptoms at the time they’re born, many of these babies have learning difficulties later in their life, and social adjustment difficulties,” Tolliver said. “It’s got to be absolutely extensive, the social cost of this.”

The Perinatal Partnership has tried to measure the problem before. Working with the West Virginia Health Care Authority, it found that medical claims for treating babies with withdrawal symptoms had doubled between 1999 and 2004, she said.

And last year, surveys showed that about 5 percent of West Virginia women reported using drugs or alcohol while pregnant.

The umbilical cord study — which was funded by the state Office of Maternal, Child and Family Health — is considered more accurate, in large part because it doesn’t rely on someone telling the truth in a survey.

The researchers analyzed 759 umbilical cord samples of babies born this August. The women and babies were anonymous.

Researchers received the specimens from eight hospitals, which tried to collect samples from every delivery: Bluefield Regional Medical Center, Raleigh General Hospital in Beckley, Thomas Memorial Hospital in South Charleston, Charleston Area Medical Center, Cabell Huntington Hospital, Ruby Memorial Hospital in Morgantown, Wheeling Hospital, and City Hospital in Martinsburg.

The study revealed geographical differences.

Alcohol use ranged from 1 percent at Cabell Huntington to 15 percent at Wheeling Hospital.

A few drinks during pregnancy wouldn’t show up in lab tests, Chaffin said: “It appears that it takes at least two or three drinks a day for a couple weeks to start showing up.”

Drug use was most common among the mothers at Raleigh General, where 19 percent of the umbilical cords tested positive. It was lowest at City Hospital in Martinsburg and Thomas Memorial Hospital in South Charleston, at 10 percent.

None of the samples tested positive for cocaine or for buprenorphine, which is used to treat opiate addiction. Only one tested positive for amphetamines.

The researchers didn’t test for nicotine. West Virginia has the nation’s highest rate of smoking among pregnant women, at 27 percent. Smoking during pregnancy has been shown to increase the risk of premature and underweight babies.

Not all of the babies are addicted to the drugs to which they were exposed, Chaffin said. Treating an infant who is addicted can cost up to $36,000, he said, compared to $2,000 for a healthy one.

“Then there’s the societal cost of having reduced function in one in five of the children born,” he said. “These troubled or damaged babies have been born into families that are already dysfunctional, and are more likely, perhaps, to perpetuate the problem.”

Early intervention is crucial, Tolliver said. But many women are afraid to tell their doctors they use illegal drugs, and could avoid prenatal checkups because of that fear.

This year, state lawmakers passed the “Uniform Maternal Screening Act,” which requires all maternity health providers to screen for pregnancy risks, including substance abuse. The health provider cannot report the mother’s answers to police or Child Protective Services during the pregnancy.

The mother could still be reported if her baby is in danger after birth, she said. The state Department of Health and Human Resources is working to implement the program, which could be ready by spring.

Last month, a report requested by Gov. Joe Manchin outlined a statewide strategy to fight drug and alcohol addiction. The plan doesn’t specifically address mothers and babies, but some lawmakers say they are hopeful the issue will get attention because the governor has indicated a commitment to tackling substance abuse problems.

Chaffin presented the study to a legislative committee on health last week.

“I think the results were a shocker to the committee members,” said Sen. Evan Jenkins, D-Cabell. “It’s the comprehensiveness of the study and the clear proof that the problem is worse” than previously thought.

House Health and Human Resources Chairman Don Perdue said lawmakers have known that drug abuse among mothers was bad, “but now we know that we may be in crisis.”

“The issue has been on the table, but now I believe this data sets fire to it,” said Perdue, D-Wayne.

With 20,000 babies born a year in West Virginia, addiction could be hurting up to 4,000 babies annually.

Sen. Dan Foster, D-Kanawha, said he fears a “tremendous loss of human capital.”

“These children will be raised by a mother who is a substance abuser,” he said. “These kids don’t have much of a chance.”

Substance abuse among pregnant women is usually entwined with domestic violence, poverty and mental health issues, said Jeannie Clark, director of Perinatal Programs for the state Department of Health and Human Resources.

“They’re very stressed and that seems to be the common, underlying thread,” she said. “They are under so much stress that they try to cope with these problems by smoking or using drugs.”

Sixty percent of pregnant women in West Virginia earn so little money that they qualify for Medicaid, she said.

Like Chaffin, Clark said the study’s findings were not surprising. In the state’s Right from the Start program, nurses and social workers help low-income women with doctor’s appointments, child birth classes, family planning, nutrition, and other matters, she said. They often see women struggling with addiction, and can help with that, too.

Clark said she worries about the caseworkers who go to homes plagued by drugs — which often come with violence.

“It’s a crisis for us,” she said.