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Cocaine use during pregnancy: perinatal outcomes
American Journal of Epidemiology
|April 15, 1991
Summary
Maternal cocaine use significantly increases risks for adverse perinatal outcomes, including low birth weight, prematurity, and perinatal death. Cocaine use also elevates the risk of small-for-gestational-age births, regardless of smoking status.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Public Health
Background:
- Maternal substance use, particularly cocaine, is a significant concern in perinatal health.
- Understanding the specific risks associated with cocaine use during pregnancy is crucial for intervention and prevention.
Purpose of the Study:
- To investigate the association between maternal cocaine use and various adverse perinatal outcomes.
- To quantify the relative risks of specific complications linked to prenatal cocaine exposure.
Main Methods:
- Retrospective cohort study using data from 17,466 non-Asian singleton deliveries in 1988.
- Comparison of outcomes between cocaine users and non-users (no drug or alcohol use).
- Adjusted relative risks (RR) and 95% confidence intervals (CI) were calculated.
Main Results:
- Maternal cocaine use was associated with elevated risks of low birth weight (RR=2.8), prematurity (RR=2.4), abruptio placentae (RR=4.5), and perinatal death (RR=2.1).
- An increased risk of intrapartum placenta previa (RR=2.3) was observed.
- Cocaine users who did not smoke had a higher risk of small-for-gestational-age births (RR=3.4) compared to those who did smoke (RR=2.1).
Conclusions:
- Cocaine use during pregnancy is linked to a higher incidence of adverse perinatal outcomes.
- Prenatal cocaine exposure increases the risk of small-for-gestational-age births, independent of maternal smoking.
- These findings underscore the importance of screening and support for pregnant individuals using cocaine.