Dos Santos Jucilene Freitas, de Melo Bastos Cavalcante Cibelle, Barbosa Fabiano Timbó, Gitaí Daniel Leite Góes, Duzzioni Marcelo, Tilelli Cristiane Queixa, Shetty Ashok K, de Castro Olagide Wagner
Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP 57072-970, Brazil.
Central-West Campus Dona Lindu, Federal University of São João del-Rei (UFSJ), Divinópolis, MG, Brazil.
Arch Gynecol Obstet. 2018 Sep;298(3):487-503. doi: 10.1007/s00404-018-4833-2. Epub 2018 Jun 27.
Crack cocaine consumption is one of the main public health challenges with a growing number of children intoxicated by crack cocaine during the gestational period. The primary goal is to evaluate the accumulating findings and to provide an updated perspective on this field of research.
Meta-analyses were performed using the random effects model, odds ratio (OR) for categorical variables and mean difference for continuous variables. Statistical heterogeneity was assessed using the I-squared statistic and risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale. Ten studies met eligibility criteria and were used for data extraction.
The crack cocaine use during pregnancy was associated with significantly higher odds of preterm delivery [odds ratio (OR), 2.22; 95% confidence interval (CI), 1.59-3.10], placental displacement (OR, 2.03; 95% CI 1.66-2.48), reduced head circumference (- 1.65 cm; 95% CI - 3.12 to - 0.19), small for gestational age (SGA) (OR, 4.00; 95% CI 1.74-9.18) and low birth weight (LBW) (OR, 2.80; 95% CI 2.39-3.27).
This analysis provides clear evidence that crack cocaine contributes to adverse perinatal outcomes. The exposure of maternal or prenatal crack cocaine is pointedly linked to LBW, preterm delivery, placental displacement and smaller head circumference.
吸食强效纯可卡因是主要的公共卫生挑战之一，孕期因吸食强效纯可卡因中毒的儿童数量不断增加。主要目标是评估积累的研究结果，并提供该研究领域的最新观点。
采用随机效应模型进行荟萃分析，分类变量采用比值比（OR），连续变量采用均值差。使用I²统计量评估统计异质性，使用纽卡斯尔-渥太华质量评估量表评估偏倚风险。十项研究符合纳入标准并用于数据提取。
孕期吸食强效纯可卡因与早产几率显著升高相关[比值比（OR）为2.22；95%置信区间（CI）为1.59 - 3.10]、胎盘前置（OR为2.03；95% CI为1.66 - 2.48）、头围减小（-1.65 cm；95% CI为-3.12至-0.19）、小于胎龄儿（SGA）（OR为4.00；95% CI为1.74 - 9.18）和低出生体重（LBW）（OR为2.80；95% CI为2.39 - 3.27）。
该分析提供了明确证据，表明吸食强效纯可卡因会导致不良围产期结局。母亲孕期或产前接触强效纯可卡因与低出生体重、早产、胎盘前置和头围较小明显相关。
