Intrauterine cocaine and crack exposure: neonatal outcome.
OBJECTIVE
Adverse health effects are associated with intrauterine cocaine exposure. The purpose of this study was to investigate the impact of fetal cocaine and crack exposure on neonatal outcome.


METHODS
We enrolled 386 mother-infant pairs, including 130 matched control pairs, in the study. The course of pregnancy and delivery was followed and neonatal outcome was assessed by physical and neurologic examination, as well as by the Brazelton Neonatal Behavioral Assessment Scale and the Neonatal Stress Scale.


RESULTS
The cocaine-exposed neonates had significantly more adverse effects than the matched control infants. Birth weight, length, and head circumference were significantly lower in the cocaine- and crack-exposed infants (p < or = 0.001). There were significantly more premature infants (p < or = 0.007) in this group. They demonstrated significant abnormalities on the neurologic examination (p < or = 0.001), inferior performance on the Brazelton Neonatal Behavioral Assessment Scale (p < or = 0.001), and higher scores on the Neonatal Stress Scale (p < or = 0.001). Predictors of negative neonatal outcome were maternal age (p < or = 0.02), poor paternal relationship with the mother (p < or = 0.002), crack use (p < or = 0.004), cocaine use (p < or = 0.009), and marijuana use (p < or = 0.05).


CONCLUSIONS
The single most important predictor of neonatal outcome is the frequency, quantity, and type of cocaine used.
Datta-Bhutada
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S
Department of Pediatrics, Babies and Childrens Hospital, Columbia University, New York, N.Y., USA.
Johnson
H L
HL
Rosen
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TS
D000328:Adult; D003042:Cocaine / Q000009:adverse effects*; D016578:Crack Cocaine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D018730:Infant Behavior / Q000187:drug effects; D007231:Infant, Newborn / Q000502:physiology / Q000523:psychology; D008137:Longitudinal Studies; D009460:Neurologic Examination; D010332:Paternal Behavior; D011247:Pregnancy; D011256:Pregnancy Outcome; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies
D016578:Crack Cocaine; D003042:Cocaine