产前使用可卡因对母亲特征及新生儿结局的影响。

The impact of antenatal cocaine use on maternal characteristics and neonatal outcomes.

作者信息

Ogunyemi D, Hernández-Loera G E

机构信息

King Drew Medical Center/UCLA School of Medicine, Los Angeles, CA, USA.

出版信息

J Matern Fetal Neonatal Med. 2004 Apr;15(4):253-9. doi: 10.1080/14767050410001668635.

DOI:10.1080/14767050410001668635

PMID:15280134

Abstract

OBJECTIVE

To determine the risk factors and evaluate maternal and neonatal outcomes associated with antenatal cocaine use.

METHODS

This was a retrospective case-control study of 200 cocaine-exposed maternal-neonatal pairs and 200 controls from 1991 to 2000.

RESULTS

Cocaine-using mothers tended to be older, African American, multiparous and incarcerated and they utilized less prenatal care. However, 79% of Hispanics abusing cocaine were primarily English speaking. Cocaine use correlated with syphilis (36 vs. 1%, p = 0.000) and premature rupture of membranes (23 vs. 0%, p = 0.000), fetal demise (5 vs. 0%, p = 0.004), preterm delivery (40 vs. 6%, p = 0.000). Cocaine-exposed infants delivered earlier (36 vs. 39 weeks, p = 0.000), had lower birth weights (2660 vs. 3305 g, p = 0.000), more respiratory distress syndrome (14 vs. 4%, p = 0.001), congenital syphilis (12 vs. 1%, p = 0.000) and longer hospital stays (10 vs. 3 days, p = 0.000); 75% were placed in foster care or adoption and 37.5% had neonatal withdrawal syndrome. There was a stronger positive correlation between neonatal withdrawal and maternal urine toxicology (rho = 0.443, p = 0.000) than with neonatal urine screen (rho = 0.278, p = 0.003).

CONCLUSION

Cocaine use in pregnancy is associated with acculturation, lack of prenatal care, and significant social and obstetric complications resulting in increased neonatal morbidity secondary to prematurity, congenital infection and withdrawal syndrome.

摘要

目的

确定与产前使用可卡因相关的危险因素，并评估母婴结局。

方法

这是一项回顾性病例对照研究，研究对象为1991年至2000年间的200对可卡因暴露母婴对和200名对照。

结果

使用可卡因的母亲往往年龄较大、为非裔美国人、多产且被监禁，她们接受的产前护理较少。然而，79%滥用可卡因的西班牙裔主要说英语。可卡因使用与梅毒（36%对1%，p = 0.000）、胎膜早破（23%对0%，p = 0.000）、胎儿死亡（5%对0%，p = 0.004）、早产（40%对6%，p = 0.000）相关。暴露于可卡因的婴儿出生较早（36周对39周，p = 0.000），出生体重较低（2660克对3305克，p = 0.000），呼吸窘迫综合征更多（14%对4%，p = 0.001），先天性梅毒（12%对1%，p = 0.000），住院时间更长（10天对3天，p = 0.000）；75%被安置在寄养或收养机构，37.5%有新生儿戒断综合征。新生儿戒断与母亲尿液毒理学之间的正相关性（rho = 0.443，p = 0.000）比与新生儿尿液筛查之间的相关性（rho = 0.278，p = 0.003）更强。