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Gestational cocaine exposure and intrauterine growth: maternal lifestyle study
Henrietta S Bada1, Abhik Das, Charles R Bauer
1The University of Kentucky, Lexington, Kentucky 40536, USA. hbada@uky.edu
Insights
In utero cocaine exposure causes significant intrauterine growth deceleration, particularly after 32 weeks of gestation. This impacts birth weight, length, and head circumference, worsening as pregnancy progresses.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Health
- Developmental Pediatrics
Background:
- Prenatal exposure to substances of abuse is a significant concern.
- Cocaine use during pregnancy can impact fetal development.
- Understanding the timing and extent of growth deviations is crucial for intervention.
Purpose of the Study:
- To quantify the impact of prenatal cocaine exposure on fetal growth.
- To determine the gestational age at which growth deviations become apparent.
Main Methods:
- Secondary analysis of the multicenter Maternal Lifestyle Study data.
- Inclusion of 1072 cocaine-exposed and 7565 cocaine-negative infants.
- Assessment of birth weight, length, and head circumference as outcome measures.
Main Results:
- Cocaine-exposed infants showed growth deceleration after 32 weeks' gestation.
- Significant interaction between cocaine exposure and gestational age was observed.
- At 40 weeks, cocaine exposure was linked to reduced birth weight (-151 g), length (-0.71 cm), and head circumference (-0.43 cm).
Conclusions:
- Prenatal cocaine exposure is associated with significant intrauterine growth deceleration.
- The negative effects on growth measurements become more pronounced with advancing gestational age.
Objective:
To estimate the effects of cocaine exposure on intrauterine growth and to investigate at what point in gestation growth deviation would be manifested.
Methods:
This is a secondary analysis of data from a multicenter project, the Maternal Lifestyle Study, designed to determine infant outcomes of in utero cocaine or opiates exposure. Four centers of the National Institute of Child Health and Human Development Neonatal Research Network enrolled 11,811 maternal-infant dyads. A total of 1072 infants were cocaine exposed, 7565 were cocaine negative by maternal history and meconium results, and 3174 were excluded from analysis because of unconfirmed negative exposure. Outcome measures included birth weight, length, and head circumference.
Results:
Percentile estimates for birth weight, length, and head circumference revealed growth deceleration in cocaine-exposed infants evident after 32 weeks' gestation. There was significant interaction between cocaine and gestational age. After controlling for confounders, at 40 weeks' gestation, cocaine exposure was estimated to be associated with a decrease of 151 g, 0.71 cm, and 0.43 cm in birth weight, length, and head circumference, respectively. Smoking had a negative impact on all growth measurements, with some indication of a dose-effect relationship. Heavy alcohol use was associated with decrease in weight and length only. Opiates had significant effect only on birth weight.
Conclusion:
In utero cocaine exposure is associated with growth deceleration involving all measurements, becoming more pronounced with advancing gestation.