Direct and indirect interactions of cocaine with childbirth outcomes.
OBJECTIVE
To evaluate neonatal sequelae of maternal cocaine use during pregnancy.


METHODS
One hundred women positive for cocaine use during pregnancy were compared with 100 matched controls who did not use cocaine. Maternal characteristics and infant neonatal outcomes were compared. We used t tests, chi 2, and multiple regression analyses to evaluate the contributions of cocaine vs other drugs to outcome.


RESULTS
Cocaine was the best predictor of increased incidence of abortions, higher maternal gravidity, and poorer prenatal care. Cocaine was also the best predictor of preterm birth and of lower birth weight, after controlling for prematurity. Maternal use of cocaine and alcohol in combination was the best predictor of decreased linear growth, after controlling for prematurity.


CONCLUSIONS
Maternal cocaine use predicts negative birth outcomes directly, as well as through obstetric risk factors of abortion history and less prenatal care. Interactive effects of cocaine and alcohol should be considered in future studies of birth outcomes.
Singer
L
L
Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Arendt
R
R
Song
L Y
LY
Warshawsky
E
E
Kliegman
R
R
D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D002188:Cannabis; D003042:Cocaine; D004357:Drug Synergism; D000431:Ethanol; D005260:Female; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D019966:Substance-Related Disorders / Q000150:complications*
D000431:Ethanol; D003042:Cocaine