title: Cocaine use and preterm premature rupture of membranes: improvement in neonatal outcome.
abstract: OBJECTIVE
  Our aim was to determine whether cocaine use increases neonatal morbidity in patients with preterm premature rupture of membranes.
  
  
  METHODS
  We reviewed records of pregnancies that were complicated with preterm premature rupture of membranes between 24 weeks to 34 weeks of gestation. Clinical characteristics and neonatal outcomes of patients who had positive results for cocaine in the urine were compared with patients with negative test results.
  
  
  RESULTS
  During the study period, 16.1% (85/528 patients) had a positive result in a urine screen for cocaine use. Patients who used cocaine were older and of higher gravidity and parity. When major neonatal morbidities were compared, there was improvement in morbidities that were linked to neonatal infection in patients with positive test results for cocaine, including pneumonia (3.5% vs 11.7%; P =.012) and sepsis (5.9% vs 14.7%; P =.016). Jointly, neonatal outcomes were significantly worse in the negative cocaine group (chi(2) = 5.143; P =.023).
  
  
  CONCLUSIONS
  The association of preterm premature rupture of membranes with major neonatal morbidity was unexpectedly and significantly weaker in pregnancies complicated by cocaine use.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA. jrefuerz@med.wayne.edu
authors.forename: Jerrie S
authors.initials: JS
authors.lastname: Refuerzo
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Sokol
authors.forename: Sean C
authors.initials: SC
authors.lastname: Blackwell
authors.forename: Stanley M
authors.initials: SM
authors.lastname: Berry
authors.forename: James J
authors.initials: JJ
authors.lastname: Janisse
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000209:etiology* / Q000503:physiopathology; D003042:Cocaine / Q000009:adverse effects* / Q000494:pharmacology / Q000652:urine; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000139:chemically induced* / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000503:physiopathology*; D011014:Pneumonia / Q000209:etiology* / Q000503:physiopathology; D011247:Pregnancy; D011256:Pregnancy Outcome
chemical_list: D003042:Cocaine