Cocaine use during pregnancy: prevalence and correlates

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Neonatal Medicine

Background:

• Substance use during pregnancy poses significant health risks to both mother and child.
• Accurate identification of cocaine use in pregnant populations is crucial for intervention and research.
• Previous studies highlight correlations between maternal behaviors and neonatal outcomes.

Purpose of the Study:

• To assess the prevalence of cocaine use among urban pregnant women.
• To identify demographic and behavioral correlates of cocaine use during pregnancy.
• To evaluate the need for advanced statistical methods to determine cocaine's independent risk in pregnancy.

Main Methods:

• Interviews and urine assays were conducted prenatally and postpartum.
• A cohort of 679 urban women receiving prenatal care was studied.
• Enzyme-mediated immunoassay technique with a 300 ng/mL cutoff for benzoylecgonine was used.

Main Results:

• 17% of women reported cocaine use during pregnancy; 8% tested positive via urine assay.
• 24% of cocaine users denied use when interviewed, identified solely by urine assay.
• Cocaine users showed higher rates of STDs, prior low birth weight infants, abortions, and other substance use (alcohol, cigarettes, marijuana, opiates).

Conclusions:

• Cocaine use is underreported by pregnant women, underscoring the importance of objective testing.
• Maternal cocaine use is associated with numerous risk factors, complicating outcome attribution.
• Multivariate analysis is essential to ascertain if cocaine use presents an independent risk for adverse neonatal outcomes.