Evaluation of the relationship between cocaine and intraventricular hemorrhage

To evaluate the relationship of cocaine to intraventricular hemorrhage in preterm (< or = 37 weeks gestation) infants, the charts of infants admitted to an intensive care nursery over a 2-year period were reviewed. Data were extracted regarding intrauterine exposure to cocaine, head ultrasonography, and specific independent variables: gestational age, 5-minute Apgar score, and the presence of pneumothorax. These variables were classified into high-, moderate-, and low-risk groups for the development of intraventricular hemorrhage. Analysis was done using chi-square, Mantel-Haentzel tests, crude odds ratio with 95% tests, crude odds ratio with 95% confidence intervals, and stepwise multiple logistic regression analysis. Intraventricular hemorrhage developed in 24 (22%) cocaine-exposed infants versus 49 (20%) nonexposed infants. Thirteen (12%) infants exposed to cocaine developed grades I to II and 11 (10%) developed grades III to IV intraventricular hemorrhage. The figures in the nonexposed infants were 29 (12%) and 20 (8%), respectively. Intraventricular hemorrhage was more likely to occur in infants who belonged to the high-risk groups: gestational age < or = 30 weeks, 5-minute Apgar score < or = 5, and the presence of pneumothorax. Pneumothorax was the single most significant factor associated with intraventricular hemorrhage grades III to IV. Intrauterine exposure to cocaine does not seem to influence the prevalence or severity of intraventricular hemorrhage in the preterm infant.