Richardson G A, Day N L, McGauhey P J
Western Psychiatric Institute and Clinic, University of Pittsburgh, School of Medicine, PA 15213.
Clin Obstet Gynecol. 1993 Jun;36(2):302-18. doi: 10.1097/00003081-199306000-00010.
The prevalence of cocaine use by pregnant women has been estimated by various researchers to range from 8-17%. Women who use cocaine during pregnancy are usually older and black and use more of other drugs. The effects of prenatal cocaine use on a variety of outcomes have not been substantiated. For each outcome discussed, there are as many reports of no effects as there are reports of detrimental effects. The studies that indicate that there are no effects of exposure are generally more sound methodologically. It is also possible that there are additional investigations of prenatal cocaine use that have not been published because of the hesitancy to publish reports in which no effects have been found. The findings regarding obstetric complications are equivocal. Although some investigators have demonstrated significant effects of cocaine use during pregnancy, particularly on abruptio placentae, many of these relationships disappear when factors such as prenatal care and polydrug use are assessed. The same pattern can be noted for the effects of prenatal cocaine exposure on gestational age, growth, and morphology. Significant effects of prenatal cocaine use on these outcomes have been reported by some investigators. However, these results are found generally in studies where poly-drug-cocaine users are compared with non-drug-using women. Such comparisons do not control adequately for other factors in the lifestyles of the cocaine-using woman. There are few significant differences when the offspring of cocaine-using women are compared with those of women who use other drugs. It is difficult to evaluate the effects of prenatal cocaine use on either neonatal neurobehavioral outcomes or on long-term growth and development because of the insufficient number of studies and the equivocal findings. Longitudinal studies are needed to disentangle the effects of cocaine use from the effects of the lack of prenatal care, polydrug use, and the increased risks associated with a drug-using life style.
不同研究人员估计，孕妇使用可卡因的比例在8%至17%之间。孕期使用可卡因的女性通常年龄较大，为黑人，且使用更多其他药物。产前使用可卡因对多种结果的影响尚未得到证实。对于所讨论的每种结果，无影响的报告数量与有害影响的报告数量一样多。表明无影响的研究在方法上通常更可靠。也有可能存在一些关于产前使用可卡因的额外调查尚未发表，因为人们对发表未发现影响的报告有所犹豫。关于产科并发症的研究结果并不明确。尽管一些研究人员已经证明孕期使用可卡因有显著影响，特别是对胎盘早剥，但在评估产前护理和多药使用等因素时，其中许多关联就消失了。产前可卡因暴露对胎龄、生长和形态的影响也呈现相同模式。一些研究人员报告了产前使用可卡因对这些结果有显著影响。然而，这些结果通常出现在将多药 - 可卡因使用者与非吸毒女性进行比较的研究中。这种比较没有充分控制使用可卡因女性生活方式中的其他因素。将使用可卡因女性的后代与使用其他药物女性的后代进行比较时，几乎没有显著差异。由于研究数量不足且结果不明确，很难评估产前使用可卡因对新生儿神经行为结果或长期生长发育的影响。需要进行纵向研究，以区分使用可卡因的影响与缺乏产前护理、多药使用以及与吸毒生活方式相关的增加风险的影响。
