Graham K, Koren G
Department of Pediatrics, Hospital for Sick Children, Toronto, Ont.
CMAJ. 1991 Mar 1;144(5):563-8.
To determine the characteristics of pregnant women exposed to cocaine.
Case-control study.
Women attending the Motherisk Program, Hospital for Sick Children, Toronto, from September 1985 to March 1990.
All women who had admitted using cocaine before or during pregnancy. Of the two control groups the first comprised women who had admitted using cannabinoids but not cocaine before or during pregnancy and the second those who attended the clinic just before the cocaine case but who had not used illicit drugs.
Age, marital status, ethnic background, number of pregnancies, children and elective or spontaneous abortions, socioeconomic status of woman and male partner, alcohol use, cigarette use, frequency of cocaine use and total amount taken.
Of the 1625 women 91 (5.6%) admitted to using cocaine: 86 during the current pregnancy, 3 before the current pregnancy, 1 before planning a pregnancy and 1 during a previous pregnancy. None of the cocaine users were considered to be addicts; only 20% had used the drug more than 10 times. A total of 74 women used cannabinoids only. The mean age of the cocaine users was 27.1 (standard deviation [SD] 5.3) years; this was significantly lower than that of the control subjects (30.5 [SD 5.2] years) (p less than 0.001). More of the cocaine users than of the women in either of the two control groups were single (60% v. 38% and 14%, p less than 0.001). The cannabinoid users had significantly higher parity and the nonusers a significantly lower incidence of elective abortions than the cocaine users. The cocaine users had a significantly lower socioeconomic status than the control subjects (p less than 0.001); similarly, the male partners of the cocaine users had a significantly lower socioeconomic status than the partners of the control subjects (p = 0.001).
Pregnant cocaine users who seek drug counselling represent a unique risk group, with clustering of factors such as alcohol and cigarette use and low socioeconomic status that compound the risk to the fetus. New strategies should be explored to identify such women, especially addicts, in their communities and to urge them to seek counselling and treatment.
确定接触可卡因的孕妇的特征。
病例对照研究。
1985年9月至1990年3月期间，在多伦多病童医院母婴风险项目就诊的女性。
所有在怀孕前或怀孕期间承认使用过可卡因的女性。在两个对照组中，第一组包括在怀孕前或怀孕期间承认使用过大麻但未使用过可卡因的女性，第二组包括在可卡因使用者就诊前刚到诊所但未使用过非法药物的女性。
年龄、婚姻状况、种族背景、怀孕次数、子女数以及选择性或自然流产情况、女性及其男性伴侣的社会经济状况、饮酒情况、吸烟情况、可卡因使用频率及使用总量。
在1625名女性中，91名（5.6%）承认使用过可卡因：86名在本次怀孕期间使用，3名在本次怀孕前使用，1名在计划怀孕前使用，1名在之前的怀孕期间使用。没有一名可卡因使用者被认为是成瘾者；只有20%的人使用该药物超过10次。共有74名女性仅使用过大麻。可卡因使用者的平均年龄为27.1岁（标准差[SD]5.3）；这显著低于对照组受试者（30.5岁[SD 5.2]）（p<0.001）。可卡因使用者中单身的比例高于两个对照组中的任何一组女性（60%对38%和14%，p<0.001）。大麻使用者的产次显著更高，非使用者的选择性流产发生率显著低于可卡因使用者。可卡因使用者的社会经济地位显著低于对照组受试者（p<0.001）；同样，可卡因使用者的男性伴侣的社会经济地位显著低于对照组受试者的伴侣（p = 0.001）。
寻求药物咨询的怀孕可卡因使用者是一个独特的风险群体，存在诸如饮酒、吸烟和社会经济地位低等多种因素聚集的情况，这些因素增加了对胎儿的风险。应探索新的策略，以便在社区中识别此类女性，尤其是成瘾者，并敦促她们寻求咨询和治疗。
