Singer L, Arendt R, Song L Y, Warshawsky E, Kliegman R
Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Arch Pediatr Adolesc Med. 1994 Sep;148(9):959-64. doi: 10.1001/archpedi.1994.02170090073014.
To evaluate neonatal sequelae of maternal cocaine use during pregnancy.
One hundred women positive for cocaine use during pregnancy were compared with 100 matched controls who did not use cocaine. Maternal characteristics and infant neonatal outcomes were compared. We used t tests, chi 2, and multiple regression analyses to evaluate the contributions of cocaine vs other drugs to outcome.
Cocaine was the best predictor of increased incidence of abortions, higher maternal gravidity, and poorer prenatal care. Cocaine was also the best predictor of preterm birth and of lower birth weight, after controlling for prematurity. Maternal use of cocaine and alcohol in combination was the best predictor of decreased linear growth, after controlling for prematurity.
Maternal cocaine use predicts negative birth outcomes directly, as well as through obstetric risk factors of abortion history and less prenatal care. Interactive effects of cocaine and alcohol should be considered in future studies of birth outcomes.
评估孕期母亲使用可卡因对新生儿的后遗症。
将100名孕期使用可卡因呈阳性的女性与100名匹配的未使用可卡因的对照者进行比较。比较母亲特征和婴儿的新生儿结局。我们使用t检验、卡方检验和多元回归分析来评估可卡因与其他药物对结局的影响。
可卡因是流产发生率增加、母亲妊娠次数增加和产前护理较差的最佳预测因素。在控制早产因素后，可卡因也是早产和低出生体重的最佳预测因素。在控制早产因素后，母亲同时使用可卡因和酒精是线性生长减缓的最佳预测因素。
母亲使用可卡因直接预示着不良的出生结局，同时也通过流产史和较少的产前护理等产科风险因素起作用。在未来关于出生结局的研究中应考虑可卡因和酒精的交互作用。
