The biologic and social consequences of perinatal cocaine use in an inner-city population: Results of an anonymous cross-sectional study

Perinatal Substance Abuse: The Impact of Reporting Infants to Child Protective Services

“…1,2 In the past decade, the medical literature has focused on the potential impact of maternal substance abuse on the fetus and subsequent child development. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] The sequelae of intrauterine drug exposure include impaired fetal growth, [17][18][19][20][21][22][23] prematurity, 24 neurologic deficits, [25][26][27] behavioral changes, 28 -33 developmental delays, 34 sudden infant death syndrome (SIDS), [35][36][37][38][39][40] and increased risk for child abuse. [41][42][43] Because of the perception that drug-using mothers are unable to care for their infants adequately, or that drugaffected environments are unsafe for infants, hospitals have taken measures to identify infants exposed to drugs during pregnancy, and child protective authorities in many jurisdictions have acted to separate the infants from their mothers at birth.…”

Issues in prenatal cocaine use research: Problems in identifying users and choosing an appropriate comparison group

“…Although some studies have included only subjects with urine screens positive for cocaine metabolites at delivery (Chouteau, Namerow, & Leppert, 1988;Gillogley, Evans, Hansen, Samuels, & Batra, 1990;Hollinshead et al, 1990;McCalla et al, 1991;Neerhof, MacGregor, Retzky, & Sullivan, 1989;Oro & Dixon, 1987;Spence, Williams, DiGregorio, KirbyMcDonnell, & Polansky, 1991), this selection process excludes admitted users and misclassifies nonadmitting users when these women did not use within a few days prior to delivery. For example, Spence et al (1991) included 18 (5.2%) women, who admitted prenatal cocaine use but had negative urine specimens at delivery, in the "cocaine-negative" group for comparison with urine-positive users.…”

“…These studies all reflect a poorer pregnancy outcome for the cocaine-using pregnant woman. The few studies that have either matched groups on important factors that affect outcome or have been large enough t o use multivariate statistics to control for confounding variables have also shown an independent negative effect of cocaine use on pregnancy outcome (Dombrowski, Wolfe, Welch, & Evans, 1991;Eyler, Behnke, Conlon, Woods, & Frentzen, 1994;Frank et al, 1990;McCalla et al, 1991;Zuckerman et al, 1989).…”

“…Several problems exist in the studies reported to date: (1) studies have not taken into account other drug use (Chouteau et al, 1988); (2) secondary drug use was identified but not taken into account in data analysis (Dombrowski et al, 1991;Handler, Kistin, Davis, & F e d , 1991;MacGregor et al, 1987;Spence et al, 1991); and (3) comparison groups were chosen with similar secondary drug use patterns but sample size prohibited using appropriate statistical analyses to determine the impact of multiple drugs on outcome (Bingol et al, 1987;Chasnoff et al, 1985). Only a few studies have taken secondary drug use patterns into account in their analyses of outcome (Frank et al, 1990;McCalla et al, 1991;Zuckerman et al, 1989).…”

A cohort study of the impact of perinatal drug use on prematurity in an inner-city population.

“…3,6 We studied the urine of 1111 inner-city women who delivered over a 4½ month period, and found that cocaine metabolites in the urine of parturients were associated with decreased use of prenatal care services, higher parity, more sexually transmitted diseases, lower birthweight, and more preterm births. [7][8] In the present study, we estimate the impact of drug use on low birthweight and prematurity in an inner-city community. …”