Peripartum cocaine use and adverse pregnancy outcome

✍ Scribed by Bertis B. Little; Laura M. Snell; Kenneth J. Trimmer; Susan M. Ramin; Fred Ghali; Craig A. Blakely; Andrea Garret

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 55 KB
• Volume: 11
• Category: Article
• ISSN: 1042-0533
• DOI: 10.1002/(sici)1520-6300(199909/10)11:5<598::aid-ajhb3>3.0.co;2-l

✦ Synopsis

The objective of the study was to analyze possible adverse effects of peripartum cocaine use on maternal and fetal outcomes. Informed consent was given by 720 (97%) of 740 women who delivered consecutively at a large urban public hospital to test an umbilical cord blood sample for the presence of non-medically administered drugs of abuse and alcohol and to be interviewed for the study. Samples were tested for the presence of a cocaine metabolite (benzoylecgonine-BZE) by radioimmunoassay. The presence of other substances of abuse (alcohol, methamphetamine, opiates) resulted in exclusion from the sample of 143 subjects. Thus, in this cohort analysis, drug-free controls (N ‫ס‬ 469) were compared to those positive for cocaine only (N ‫ס‬ 108). Peripartum exposure to cocaine only, and no other substances of abuse, was associated with an increased frequency of abruptio placentae (1.9% vs 0% for control, P < 0.004), thick meconium stained amniotic fluid (3.9% vs 0.7% for controls, P < 0.006), premature rupture of membranes (P < 0.02), genitourinary anomalies (OR ‫ס‬ 3.6, P < 0.05), abdominal wall defects (OR ‫ס‬ 4.4, P < 0.01) and increased frequency of low birth weight (OR ‫ס‬ 2.0, P < 0.02). These are important findings because previous studies have been complicated by the confounding effects of other substances of abuse. Am.