Schutzman D L, Frankenfield-Chernicoff M, Clatterbaugh H E, Singer J
Department of Pediatrics, Mercy Catholic Medical Center, Darby, Pennsylvania.
Pediatrics. 1991 Oct;88(4):825-7.
This study endeavored to determine the incidence of intrauterine cocaine exposure in a socioeconomically mixed suburban setting. It also assessed the effectiveness of an anonymous questionnaire in eliciting information on maternal use of illicit drugs during pregnancy. Meconium was collected from 500 consecutively born infants and analyzed for the presence of cocaine and its metabolites. An anonymous two-page questionnaire also was distributed to all postpartum mothers. Of the infants' mothers, (73.2%) were covered by some form of insurance (private), whereas 26.8% either had no insurance or were covered by Medicaid (clinic). Fifty-nine (11.8%) babies tested positive for cocaine. The meconium of 6.3% of the babies whose mothers had private insurance tested positive, while the meconium of 26.9% of the babies whose mothers had Medicaid or no insurance tested positive. 316 (63.2%) of the mothers returned a questionnaire. 73% had private insurance and 27% were covered by Medicaid (clinic). Only five mothers with no insurance or covered by Medicaid admitted using cocaine. It appears that neonatal exposure to cocaine may be an even greater problem than previously imagined, particularly in the private population. In addition, anonymous maternal self-reporting forms probably will not be helpful in identifying infants at risk for illicit exposure to drugs.
本研究致力于确定在一个社会经济状况混杂的郊区环境中宫内可卡因暴露的发生率。它还评估了一份匿名问卷在获取孕期母亲使用非法药物信息方面的有效性。从500名连续出生的婴儿中收集胎粪，并分析其中可卡因及其代谢物的存在情况。一份两页的匿名问卷也分发给了所有产后母亲。在婴儿母亲中，73.2% 有某种形式的保险（私人保险），而26.8% 要么没有保险，要么由医疗补助计划（诊所）承保。59名（11.8%）婴儿可卡因检测呈阳性。母亲有私人保险的婴儿中，6.3% 的胎粪检测呈阳性，而母亲有医疗补助计划或没有保险的婴儿中，26.9% 的胎粪检测呈阳性。316名（63.2%）母亲返还了问卷。73% 有私人保险，27% 由医疗补助计划（诊所）承保。只有五名没有保险或由医疗补助计划承保的母亲承认使用过可卡因。看来新生儿可卡因暴露可能是一个比之前想象的更严重的问题，尤其是在有私人保险的人群中。此外，匿名的母亲自我报告表格可能无助于识别有非法药物暴露风险的婴儿。
