Smoking and illicit drug use during pregnancy: impact on neonatal outcome.
OBJECTIVE
To examine the effects of maternal substance use on neonatal outcomes in 212 pregnant cocaine/opiate dependent women who delivered while in active drug treatment.


METHODS
Using urine toxicology data at delivery, subjects were classified drug positive (+TOX) (n = 53) or negative (-TOX) (n = 159).


RESULTS
Toxicology status was not associated with maternal or neonatal demographic or drug use variables. +TOX patients were enrolled in the treatment program for a shorter period of time than -TOX (68.3 vs. 91.3 days, p = 0.005). Infant birth weight ratio (IBR) was lower in +TOX women (0.84 vs. 0.90, p = 0.003). +TOX women were twice as likely to have small-for-gestational-age (IBR < 0.85) neonates than were -TOX. Length of stay (LOS) in the neonatal intensive care unit (NICU) was not associated with maternal toxicology but was associated with quantity of tobacco per day (p = 0.0001). NICU neonates with heavily smoking mothers (11+ cigarettes/day) averaged LOS = 9.5 days as compared to light (1-10 cigarettes per day) smokers (LOS = 7.9 days) and nonsmokers (LOS = 5.5 days).


CONCLUSIONS
Maternal drug abstinence is associated with higher IBR. Maternal smoking is related to NICU LOS, even among polydrug-dependent women. These data are clinically and economically important and support the need for smoking cessation interventions in high-risk populations, such as drug-dependent pregnant women.
Miles
Donna R
DR
Department of Human Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond 23298-0003, USA. dmiles@hsc.vcu.edu
Lanni
Susan
S
Jansson
Lauren
L
Svikis
Dace
D
D000328:Adult; D001034:Apgar Score; D019970:Cocaine-Related Disorders / Q000150:complications*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008425:Maternal Behavior; D009293:Opioid-Related Disorders / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced* / Q000517:prevention & control; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation; D016320:Substance Abuse Treatment Centers