Cocaine abuse during pregnancy: correlation between prenatal care and perinatal outcome

Article Abstract:

Cocaine abuse during pregnancy is associated with increased mortality and complications around the time of birth, and studies evaluating the effects of better prenatal care for cocaine-abusing mothers have found, unfortunately, few positive effects. To learn more about this issue, the outcome of pregnancy for 120 cocaine-abusing women who received comprehensive prenatal care (group 1) was compared with the outcome for 21 cocaine abusers who received little or no prenatal care (group 2). Group 1 women underwent counseling and treatment by a multidisciplinary team that included specialists in pediatrics, obstetrics, psychiatry, social services, nursing and nutrition. A third group (controls) consisted of 120 pregnant women who did not use cocaine. Results showed that group 1 women and controls had a similar number of prenatal visits (between 9 and 10). Few women in any group developed complications during pregnancy. The average gestational age at delivery and average birth weight, however, were lower for group 2 than group 1 women, which, in turn, were lower than for controls. A greater proportion of pregnancies in group 2 than group 1 ended in either premature delivery or abruptio placentae (premature detachment of the placenta). Control group women had a significantly smaller proportion of preterm (premature) deliveries than women in either of the cocaine-abusing groups, although they had the same incidence of abruptio placentae and congenital defects. Apgar scores (a measure of physical function in newborns) were similar for all three groups, but infants born to group 2 mothers had lower (more acidic) blood pH. The results showed a positive effect of the extensive prenatal counseling and care among group 1 women, but even with such care, these women had babies with lower birth weights and lower gestational ages than women who were not abusing cocaine. Thus better prenatal care cannot compensate for the damage caused by cocaine use. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Evaluation, Prenatal care

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Substance abuse in pregnant women: recent experience at the Perinatal Center for Chemical Dependence of Northwestern Memorial Hospital

Article Abstract:

Infants may develop many complications due to drug abuse by mothers during pregnancy. Patterns of abuse have changed in the 1980s. Drug usage has increased among women of reproductive age and cocaine is becoming a first substance for abuse because it is widely available, need not be injected and, in its smokable form, is cost competitive with alcohol. The outcomes of pregnancies were compared between mothers who used drugs and those who did not. Infants of drug-abusing mothers were born sooner and had significantly lower weights at birth than infants of mothers who did not use drugs. During pregnancy, drug-using mothers required more frequent hospitalization and were subject to abruptio placentae. The effect of substance abuse on illnesses and death associated with pregnancy is likely to continue and programs need to be devised to deal with the complex issues related to this problem.

Case studies, Substance abuse, Pregnancy, Complications of, Pregnancy complications

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Temporal patterns of cocaine use in pregnancy: perinatal outcome

Article Abstract:

Pregnant women who used cocaine in only the first trimester of pregnancy did not have an increased number of premature births or low-birth-weight babies, although the women who used cocaine throughout pregnancy experienced these in addition to increased interuterine growth retardation. Perinatal outcomes for these two groups of women were compared with perinatal outcomes fo a group of obstretic patients with no history or evidence of substance abuse. The group of women who used cocaine throughout pregnancy also had reductions in average birth weigh, length and head circumference. However, in the study of 75 women who were enrolled in a comprehensive perinatal care program, both groups of cocaine-exposed infants demonstrated significant impairment of orientation, motor and regulation behaviors on the Neonatal Behavioral Assessment Scale.

Analysis, Maternal-fetal exchange, Fetus, Medical examination, Pregnant women, Infants (Newborn), Drug use, Neonatal screening

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