ACCELERATED FETAL LUNG MATURITY PROFILES AND MATERNAL COCAINE EXPOSURE

Objective: To determine the effect of maternal cocaine exposure on fet al lung maturity as measured by surfactant-albumin ratios determined b y the TDx-FLM test. Methods: A case-control study design was used to c ompare fetal lung maturity as assessed by a surfactant-albumin ratio a ssay (TDx-FLM) in amniotic fluid (AF) obtained from women who were kno wn to use cocaine and those who were not known to use cocaine during t he study pregnancy. Multiple logistic regression procedures were used to control for gestational age and possible confounders, such as obste tric and nonobstetric complications, other substance abuse, race, infa nt sex, and payer status. Results: Maternal cocaine use during pregnan cy was associated with an accelerated fetal lung maturity profile (adj usted odds ratio [OR] 2.04, 95% confidence interval [CI] 1.04-4.00) as determined by the TDx-FLM test. Other variables found to be statistic ally significant predictors of a mature fetal lung profile were cigare tte smoking during the current pregnancy (OR 1.61, 95% CI 1.02-2.56). Preterm labor, preterm rupture of membranes, nonobstetric illness duri ng pregnancy, and exposure to other abused substances were not associa ted with accelerated fetal lung maturity. Conclusion: Maternal cocaine use during pregnancy is associated with a doubling of the probability of a mature fetal lung profile as determined by TDx-FLM analysis of A F. Tobacco use is also a predictor of accelerated fetal lung maturity profiles.