Effects of cocaine on the placenta

Adverse perinatal outcomes of gravidas using cocaine is well documented, bu t the effects on the placenta have been difficult to elucidate due to confo unding factors such as concurrent use of other drugs. This study compares p athologic findings of 26 placentas from women who used only cocaine during pregnancy with findings from 26 controls. All women were from a similar soc ioeconomic class and were controlled for gestational age and tobacco use. N one of the cocaine placentas were from women whose toxicology screens were positive for drugs other than cocaine. In the 26 cocaine placentas, there was 1 infarct, 3 chronic villitis, and 1 segmental fibrosis, with none present in the controls. In the control. gro up, there was 1 decidual vasculopathy and 1 thrombus in a maternal vessel, but none were in the cocaine placentas. Each group had 1 thrombus in a feta l vessel. The study group showed 6 cases of chorioamnionitis and 1 funisiti s; the control group had 10 and 4 cases, respectively. None of the above or seven other features showed a statistically significant difference between the cases and controls. Cocaine is a potent vasoconstrictive agent that bl ocks re-uptake of norepinephrine at the adrenergic nerve terminals. Our stu dy suggests that cocaine does not cause an increased incidence of any of th e 15 clearly recognizable placental features examined.