Gillogley K M, Evans A T, Hansen R L, Samuels S J, Batra K K
Department of Obstetrics and Gynecology, University of California, Davis.
Am J Obstet Gynecol. 1990 Nov;163(5 Pt 1):1535-42. doi: 10.1016/0002-9378(90)90621-d.
Universal urine testing for cocaine, amphetamines, and opiates was performed on 1643 women admitted to an obstetric service for a 1-year period with 20.5% having positive results. There were 299 patients with positive toxicology results matched for race and discharge date with patients having negative toxicology and drug history. Significant differences in age, prior obstetric history, prenatal care, alcohol history, and smoking were noted between groups. There was a significant decrease in birth weight, head circumference, length, and gestational age for the drug-positive group, which was most marked in cocaine and multiple drug users. These differences persisted after we controlled for smoking, prenatal care, and prior preterm births. Differences in birth weight and head circumference remained after we controlled for gestational age. Rates of congenital anomalies and abruptio placental were similar between groups. Perinatal substance abuse is independently associated with growth retardation and prematurity. Multiple risk factors are frequently present, necessitating a comprehensive approach to prenatal care.
对1643名入住产科服务部门长达1年的女性进行了可卡因、苯丙胺和阿片类药物的常规尿液检测，结果显示20.5%的女性检测呈阳性。有299名毒理学检测结果呈阳性的患者，在种族和出院日期方面与毒理学检测结果为阴性且无药物史的患者相匹配。两组在年龄、既往产科病史、产前护理、饮酒史和吸烟方面存在显著差异。药物阳性组的出生体重、头围、身长和孕周显著降低，这在可卡因使用者和多种药物使用者中最为明显。在我们对吸烟、产前护理和既往早产情况进行控制后，这些差异仍然存在。在我们对孕周进行控制后，出生体重和头围的差异依然存在。两组之间先天性异常和胎盘早剥的发生率相似。围产期药物滥用与生长发育迟缓及早产独立相关。通常存在多种风险因素，因此需要采取全面的产前护理方法。
