HEALTH-CARE AND HOSPITALIZATIONS OF YOUNG-CHILDREN BORN TO COCAINE-USING WOMEN

Objectives: To examine the health care and hospitalizations of young c hildren (birth to age 2 years) born to cocaine-using women and to asse ss the extent to which premature births account for differences betwee n these children and comparison children. Design: A retrospective coho rt design using a repeat-matching method: comparison children were mat ched to subjects with exposure to cocaine on 6 sociodemographic variab les, first, without attention to gestational age and then using the ge stational age as an additional matching variable. Setting: City hospit als and primary care clinics. Subjects: Children of women giving birth at a single hospital. Main Outcome Measurer: Hospital admissions and indexes of health care use for children from birth to age 2 years. Res ults: Of the 139 subjects with exposure to cocaine, 23% were born prem aturely compared with only 6% in the first comparison (P<.001). At bir th, children with exposure to cocaine remained in the hospital longer (P<.01), but this difference was explained by the increased prevalence of prematurity. By age 2 years, these children had significantly fewe r visits for health care maintenance (P<.001), were less likely to hav e completed immunizations (P<.05), and spent more days in the hospital than comparison children. These differences were not related to prema turity, but were explained by differences in sociodemographic characte ristics. Conclusion: Although prematurity is the major reason for leng thier hospital stays at birth of children with exposure to cocaine, ad verse social factors contribute most to inadequate preventive health c are and increased stays in the hospital in subsequent years.