Relationship between Self-Reported Maternal Substance Abuse and Adverse Outcomes in the Premature Newborn.
OBJECTIVE
This study aims to compare neonatal and long-term outcomes among preterm newborns from women with reported versus those who did not report substance abuse.


METHODS
Secondary analysis of a trial of magnesium sulfate for cerebral palsy prevention. Cases were pregnant women who reported substance abuse, controls were those who denied it. Study outcomes included (1) composite neonatal morbidity, defined as any of the following: Apgar score ≤ 3 at 5 minutes, seizures, culture-proven sepsis, necrotizing enterocolitis grades 2 or 3, intraventricular hemorrhage grades 3 or 4, and/or death before discharge; (2) infant and childhood morbidity, defined as stillbirth or death by 1 year, or moderate/severe cerebral palsy by age of 2.


RESULTS
Among 1,972 women meeting the inclusion criteria, 197 (10%) reported substance abuse. Composite neonatal, infant, and childhood morbidity rates were similar between cases and controls. However, women reporting substance abuse who delivered between 32(0/7) and 36(6/7) weeks had a higher frequency of composite infant and childhood morbidity (6.5 vs. 1.0%; adjusted odds ratio, 6.5; 95% confidence interval, 1.14-36.99).


CONCLUSIONS
Preterm birth was associated with similar composite neonatal morbidity between cases and controls. After 32 weeks, self-reported substance abuse was associated with a sevenfold increase in the rates of stillbirth and long-term infant morbidity.
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, Texas.
Oscar A
OA
Viteri
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, Texas.
Hector
H
Mendez-Figueroa
Center for Clinical Research and Evidence-Based Medicine, The University of Texas Health Science Center at Houston, Houston, Texas.
Claudia
C
Pedroza
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, Texas.
Mateo G
MG
Leon
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, Texas.
Baha M
BM
Sibai
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, Texas.
Suneet P
SP
Chauhan
D000328:Adult; D001034:Apgar Score; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000453:epidemiology*; D002547:Cerebral Palsy / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D066088:Infant Death; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D002189:Marijuana Abuse / Q000453:epidemiology; D009293:Opioid-Related Disorders / Q000453:epidemiology; D066087:Perinatal Death; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012640:Seizures / Q000453:epidemiology*; D057566:Self Report; D018805:Sepsis / Q000453:epidemiology*; D050497:Stillbirth / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult