The impact of antenatal cocaine use on maternal characteristics and neonatal outcomes.
OBJECTIVE
To determine the risk factors and evaluate maternal and neonatal outcomes associated with antenatal cocaine use.


METHODS
This was a retrospective case-control study of 200 cocaine-exposed maternal-neonatal pairs and 200 controls from 1991 to 2000.


RESULTS
Cocaine-using mothers tended to be older, African American, multiparous and incarcerated and they utilized less prenatal care. However, 79% of Hispanics abusing cocaine were primarily English speaking. Cocaine use correlated with syphilis (36 vs. 1%, p = 0.000) and premature rupture of membranes (23 vs. 0%, p = 0.000), fetal demise (5 vs. 0%, p = 0.004), preterm delivery (40 vs. 6%, p = 0.000). Cocaine-exposed infants delivered earlier (36 vs. 39 weeks, p = 0.000), had lower birth weights (2660 vs. 3305 g, p = 0.000), more respiratory distress syndrome (14 vs. 4%, p = 0.001), congenital syphilis (12 vs. 1%, p = 0.000) and longer hospital stays (10 vs. 3 days, p = 0.000); 75% were placed in foster care or adoption and 37.5% had neonatal withdrawal syndrome. There was a stronger positive correlation between neonatal withdrawal and maternal urine toxicology (rho = 0.443, p = 0.000) than with neonatal urine screen (rho = 0.278, p = 0.003).


CONCLUSIONS
Cocaine use in pregnancy is associated with acculturation, lack of prenatal care, and significant social and obstetric complications resulting in increased neonatal morbidity secondary to prematurity, congenital infection and withdrawal syndrome.
Ogunyemi
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King Drew Medical Center/UCLA School of Medicine, Los Angeles, CA, USA.
Hernández-Loera
G E
GE
D000437:Alcoholism / Q000150:complications; D001724:Birth Weight / Q000187:drug effects*; D016022:Case-Control Studies; D003042:Cocaine / Q000506:poisoning*; D019970:Cocaine-Related Disorders / Q000150:complications; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D016014:Linear Models; D016015:Logistic Models; D008423:Maternal Age; D015999:Multivariate Analysis; D011247:Pregnancy; D011256:Pregnancy Outcome; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013587:Syphilis / Q000209:etiology
D003042:Cocaine