Cocaine and cigarettes: a comparison of risks

Area of Science:

• Obstetrics and Gynecology
• Perinatal Epidemiology
• Public Health

Background:

• Prenatal exposure to substances like cocaine and cigarettes poses risks to perinatal outcomes.
• Clinical, policy, and legal debates exist regarding prenatal cocaine use in the USA.

Purpose of the Study:

• To examine the effects of prenatal cocaine use on perinatal outcomes.
• To compare the relative risks of adverse perinatal outcomes between cocaine users and cigarette smokers.

Main Methods:

• Retrospective cohort study utilizing data from a large urban perinatal registry.
• Comparison of adverse perinatal outcomes among maternal cocaine users (non-smokers, no other illicit drug/alcohol use), cigarette smokers (no illicit drug/alcohol use), and unexposed women.

Main Results:

• Cocaine users exhibited significantly higher risks for low birthweight, small-for-gestational age, prematurity, abruptio placentae, and perinatal death compared to non-smoking, non-drug-using controls.
• While risks were greater for cocaine users than smokers for all outcomes, the larger population of smokers means more infants are affected by cigarette smoking.
• Placenta previa risk was elevated in cocaine users, though not statistically significant compared to controls.

Conclusions:

• The study supports concerns regarding the risks of prenatal cocaine exposure and the need for treatment interventions.
• Cigarette smoking during pregnancy remains a substantial public health risk affecting a larger number of infants.
• Both cocaine and cigarette use during pregnancy are associated with significant adverse perinatal outcomes.