DIRECT AND INDIRECT INTERACTIONS OF COCAINE WITH CHILDBIRTH OUTCOMES

Objective: To evaluate neonatal sequelae of maternal cocaine use durin g pregnancy. Methods: One hundred women positive for cocaine use durin g pregnancy were compared with 100 matched controls who did not use co caine. Maternal characteristics and infant neonatal outcomes were comp ared. We used t tests, chi(2), and multiple regression analyses to eva luate the contributions of cocaine vs other drugs to outcome. Results: Cocaine was the best predictor of increased incidence of abortions, h igher maternal gravidity, and poorer prenatal care. Cocaine was also t he best predictor of preterm birth and of lower birth weight, after co ntrolling for prematurity. Maternal use of cocaine and alcohol in comb ination was the best predictor of decreased linear growth, after contr olling for prematurity. Conclusions: Maternal cocaine use predicts neg ative birth outcomes directly, as well as through obstetric risk facto rs of abortion history and less prenatal care. Interactive effects of cocaine and alcohol should be considered in future studies of birth ou tcomes.