Cocaine use during pregnancy and health outcome after 10 years

Abstract

Background Women who used cocaine during pregnancy may become at risk for increased physical and mental health problems. Methods Three hundred and twenty-one (158 cocaine use during pregnancy (PC), 163 no cocaine (NC)) women were assessed using the Health Survey Questionnaire (SF-36V2) 10 years after infant birth. Factors related to mental and physical health, and co-occurring with PC, were evaluated using multiple regression. Results Controlling for age and education, PC women reported poorer total perceived mental health (PMH) (46.3 ± .9 vs. 50.7 ± .9, p < .001), more bodily pain (48.1 ± 1.0 vs. 51.5 ± 1.0, p < .02) and poorer health perceptions (46.8 ± .9 vs. 49.7 ± .9, p < .03) than NC women. PC women had lower BMI (29% vs. 32%, p < .006), higher current alcoholic drinks per/week (4.05 ± 15.5 vs. 1.29 ± 3.51, p < .005) and number of cigarettes per day (9 ± 10.6 vs. 4 ± 6.5, p < .0001) and greater total life strain (Family Inventory of Life Events and Changes (FILE)) (4.6 ± 4.9 vs. 3.2 ± 3.2, p < .004) than NC women. Regression analyses indicated that body mass index (BMI) mediated the effect of prior cocaine use on perceived physical health (PPH) and total life strain had additive effects. Current cigarette use and total life stress partially mediated the effects of cocaine use on PMH and also had additive independent effects. Conclusions PC use is a marker for poor health after 10 years. Mediators of these relationships (BMI, stressful life events and current tobacco use) should be considered when designing interventions to promote health.

The association of prenatal cocaine exposure, externalizing behavior and adolescent substance use

“…These results support and extend earlier research indicating that teens with PCE are at increased risk of drug use (Glantz and Chambers, 2006; Delaney-Black et al, 2011; Frank et al, 2011; Minnes et al, 2014a,b) compared to non-exposed teens of similar race and SES. Previous studies indicating that teens with PCE are almost three times more likely to have problems related to substance use than their NCE peers (Minnes et al, 2012; Min et al, 2014b) and earlier initiation of substance use (Richardson et al, 2013), raise additional concerns for potential abuse and dependence, as well as for social problems related to substance use, for this high risk group. There was an increase in the rate of past 30-day substance use from ages 15 to 17 years, indicating that prevention and/or early intervention is important to stop potential progression to abuse and dependence.…”

Trends in Drug-exposed Deliveries From 2002 to 2009

“…Having a positive test is not necessarily indicative of chronic use or women with more severe addictions. In contrast, many women decrease or abstain from substance use later in pregnancy, 8,20,21 so for some, their negative urinalysis at the time of delivery should not be interpreted as nonuse during pregnancy. Conversely, having a positive urinalysis should not be interpreted as regular use during pregnancy, as the same positive test indicates either repeated or 1-time use; level of use was not measured.…”

Pathways linking childhood maltreatment and adult physical health

“…From the life-course model, childhood maltreatment may be linked to adult health through behavioral strategies to cope with maltreatment (i.e., substance use), psychological responses (i.e., depression and anxiety), and subsequent secondary stressors that were triggered by childhood maltreatment (i.e., interpersonal problems; Pearlin, 1989; Springer, 2009), and these various behavioral, psychosocial factors influence health independently, cumulatively, and interactively (Ben-Shlomo & Kuh, 2002; Hertzman, 1999). Converging evidence from prospective and retrospective studies suggests that child maltreatment increases the risk of smoking (Chartier et al., 2009; Spratt et al, 2009), alcohol problems (Gilbert et al, 2009; Horwitz, Widom, Mclaughlin, & White, 2001; Lown, Nayak, Korcha, & Greenfield, 2011) and illicit drug use (Min, Farkas, Minnes, & Singer, 2007; Widom, Marmostein, & White, 2006), all of which have been independently associated with poorer health outcomes (Hall & Degenhardt, 2009; Minnes et al, in press; Nolen-Hoeksema, 2004; Strandberg et al, 2008). Increased risk for developing obesity has also been linked with childhood sexual abuse (Chartier et al, 2009; Noll, Zeller, Trickett, & Putnam, 2007), physical abuse (Springer, 2009), and neglect (Lissau & Sorensen, 1994).…”