Low birth weight and preterm births: etiologic fraction attributable to prenatal drug exposure.
OBJECTIVE
To determine the factors that would increase the likelihood of outcomes: low birth weight (LBW), preterm births and intrauterine growth restriction (IUGR).


METHODS
Secondary data analysis from a multi-center study. Risk factors for each outcome were derived from logistic regression models. Odds ratios (OR), 95% confidence intervals, and population-attributable risk proportions (PAR%) were estimated.


RESULTS
Prenatal cocaine exposure increased the likelihood of LBW (OR: 3.59), prematurity (OR: 1.25), and IUGR (OR: 2.24). Tobacco, but not marijuana, significantly influenced these outcomes. Alcohol had an effect on LBW and IUGR. Etiologic fractions (PAR%) attributable to tobacco for LBW, prematurity, and IUGR were 5.57, 3.66, and 13.79%, respectively. With additional drug exposure including cocaine, estimated summary PAR% increased to 7.20% (LBW), 5.68% (prematurity), and 17.96% (IUGR).


CONCLUSIONS
Disease burden for each outcome increases with each added drug exposure; however, etiologic fraction attributable to tobacco is greater than for cocaine.
Bada
Henrietta S
HS
Department of Pediatrics, College of Medicine and College of Public Health, University of Kentucky, Lexington, KY 40536, USA.
Das
Abhik
A
Bauer
Charles R
CR
Shankaran
Seetha
S
Lester
Barry M
BM
Gard
Charlotte C
CC
Wright
Linda L
LL
Lagasse
Linda
L
Higgins
Rosemary
R
D003042:Cocaine / Q000633:toxicity; D004305:Dose-Response Relationship, Drug; D005260:Female; D005317:Fetal Growth Retardation / Q000139:chemically induced / Q000209:etiology; D005333:Fetus / Q000187:drug effects*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007752:Obstetric Labor, Premature / Q000209:etiology; D011247:Pregnancy; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
D003042:Cocaine