A study of antenatal cocaine use - Chaos in action

OBJECTIVE: This study identified behaviors or conditions associated with co caine use among prenatal patients and evaluated pregnancy outcomes. STUDY DESIGN: A case-control study of patients attending a neighborhood-bas ed prenatal program was conducted. For each patient who used cocaine, the n ext prenatal registrant with both a negative history of cocaine use and a n egative urine screen for cocaine served as the control. RESULTS: Cocaine use was associated with older, multiparous women who had a history of prior low birth weight infants. Prenatal care was obtained late r and less frequently. Other substances, including tobacco, alcohol, and ma rijuana, were more commonly used. A history of physical abuse and violence, as well as incarceration, was identified more often. The prevalence of syp hilis was higher. Women who used cocaine were delivered of their infants ea rlier; prematurity occurred more often. Their infants were smaller. Regress ion analysis identified factors other than cocaine as important in either l ow birth weight or preterm delivery. Attainment of a greater number of pren atal care visits was associated with improved outcome. CONCLUSION: Women who use cocaine have numerous significant life disturbanc es, which may collectively influence pregnancy outcome. Cocaine use itself is a marker and did not appear to influence the prevalence of low birth wei ght or preterm delivery.