VASCULAR DISRUPTION BIRTH-DEFECTS AND HISTORY OF PRENATAL COCAINE EXPOSURE - A CASE-CONTROL STUDY

Objective: To test the hypothesis that prenatal cocaine exposure is as sociated with a 3-fold increased risk for vascular disruption among ma lformations, Study Design: A retrospective case-control study was base d upon >68,000 delivery records at Hutzel Hospital for a 9-year period , Ascertainment was based upon ICD-9 codes for limb defects, abdominal wall defects, and facial clefts, Transverse limb defects and gastrosc hisis were defined as cases, and nondisruption anomalies served as con trols, Statistical analysis for history of maternal cocaine use report ed during pregnancy was performed by chi(2) analysis and the odds rati o determined. Results: A total of 190 cases of limb anomalies, abdomin al wall defects, and cleft lips were identified after exclusion criter ia. Statistical analysis was performed on the 119 cases informative fo r maternal cocaine use during pregnancy, Seven of 34 vascular disrupti on cases had cocaine exposure reported versus 12 of 85 other malformat ions controls, The odds ratio for cocaine exposure and vascular disrup tion is 1.58 (95% confidence interval = 0.55-4.47), Conclusion: The pu tative association of prenatal cocaine exposure and vascular disruptio n birth defects remains unresolved, but the attributable risk is very likely less than the 3-fold odds ratio previously reported.