RELATIONSHIPS OF SERUM ILLICIT DRUG CONCENTRATIONS DURING PREGNANCY TO MATERNAL NUTRITIONAL-STATUS

Findings reported are for a subset of African American subjects, resid ing in the urban area of Washington, D. C., who participated in a Prog ram Project designed to study nutrition, other factors, and the outcom e of pregnancy. Fasting blood samples, drawn during each trimester of pregnancy and at delivery, were screened for concentrations of cocaine , phencyclidine (PCP) and marijuana. Since substance abusers are expec ted to consume inadequate diets, these samples were also analyzed for serum folate, vitamin B-12, ferritin and ascorbic acid. Data for these biochemical variaferritin and ascorbic acid. Data for these biochemic al variables were compared for subjects whose serum values for drugs w ere either above or below the drug screening threshold concentrations established by ADAMHA/NIDA. Pearson's correlations were used to determ ine relationships between pregnancy outcome variables and maternal ser um drug concentrations. Blood samples drawn at delivery showed higher maternal: cord ratios (mean +/- SEM) for marijuana (3.3 +/- 2.2) and P CP (2.9 +/- 1.0) than for cocaine (1.0 +/- 0.2). The subjects whose se rum values were above the ADAMHA/NIDA ranges for marijuana, PCP and co caine had concentrations of folate and ferritin that were significantl y less than those of subjects with lower serum drug levels (P less tha n or equal to 0.05). High maternal serum concentrations of illicit dru gs were accompanied by a significant increase in leukocyte count (P le ss than or equal to 0.05). The level of maternal cocaine during the th ird trimester was inversely correlated with birthweight (r = -0.29; n = 52; P = 0.038) and head circumference (r = -0.28; n = 52; P = 0.047) . The reduction in maternal serum folate and ferritin in women with hi gh blood concentrations of marijuana, PCP and cocaine suggests that il licit drug use within this subset of pregnant women might affect mater nal nutritional status. The inverse correlation of maternal levels of cocaine with birthweight and head circumference, and illicit drugs wit h ferritin and folate values observed in this population are worthy of further investigation.