Effects of cocaine use during pregnancy on low birthweight and preterm birth: systematic review and metaanalyses.

OBJECTIVE To review systematically maternal antenatal cocaine exposure and adverse perinatal outcomes. STUDY DESIGN Medline, Embase, CINAHL and secondary references in relevant studies were searched. English language studies of antenatal cocaine exposure and pregnancy outcomes published from 1966 to July 2009 were included. Metaanalyses were performed using the random effects model. RESULTS Thirty-one studies were included. Cocaine use during pregnancy was associated with significantly higher odds of preterm birth (odds ratio [OR], 3.38; 95% confidence interval [CI], 2.72-4.21), low birthweight (OR, 3.66; 95% CI, 2.90-4.63), and small for gestational age infants (OR, 3.23; 95% CI, 2.43-4.30), as well as shorter gestational age at delivery (-1.47 week; 95% CI, -1.97 to -0.98 week) and reduced birthweight (-492 g; 95% CI, -562 to -421 g). CONCLUSION Prenatal cocaine exposure is significantly associated with preterm birth, low birthweight, and small for gestational age infants.

[1]  L. Gilstrap,et al.  Cocaine Abuse During Pregnancy: Maternal and Fetal Implications , 1989, Obstetrics and gynecology.

[2]  D. Barker,et al.  Adult Consequences of Fetal Growth Restriction , 2006, Clinical obstetrics and gynecology.

[3]  M. Polansky,et al.  The Relationship Between Recent Cocaine Use and Pregnancy Outcome , 1991, Obstetrics and gynecology.

[4]  M. Boudreaux,et al.  A case-control study of cocaine use in pregnancy. , 1995, American journal of obstetrics and gynecology.

[5]  W. Crombleholme,et al.  Peripartum cocaine use: estimating risk of adverse pregnancy outcome , 1991, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[6]  Watson Pt,et al.  The cost of maternal cocaine abuse: I. Perinatal cost. , 1991 .

[7]  C. Theorell,et al.  Fetal and neonatal effects of maternal cocaine use. , 1991, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[8]  M. E. Sprauve,et al.  Adverse Perinatal Outcome in Parturients Who Use Crack Cocaine , 1997, Obstetrics and gynecology.

[9]  S. Thompson,et al.  Quantifying heterogeneity in a meta‐analysis , 2002, Statistics in medicine.

[10]  T. Joyce,et al.  The Association between Prenatal Care and Birth Weight among Women Exposed to Cocaine in New York City , 1993, JAMA.

[11]  A. Handler,et al.  Cocaine and cigarettes: a comparison of risks. , 1996, Paediatric and perinatal epidemiology.

[12]  J. Anthony,et al.  Intrauterine growth of full-term infants: impact of prenatal cocaine exposure. , 2001, Pediatrics.

[13]  B. A. Bernstein,et al.  Meconium testing for cocaine metabolite: prevalence, perceptions, and pitfalls. , 1993, American journal of obstetrics and gynecology.

[14]  B. Calhoun,et al.  The Cost of Maternal Cocaine Abuse: I. Perinatal Cost , 1991, Obstetrics and gynecology.

[15]  S. Samuels,et al.  The perinatal impact of cocaine, amphetamine, and opiate use detected by universal intrapartum screening. , 1990, American journal of obstetrics and gynecology.

[16]  H. Bauchner,et al.  Effects of maternal marijuana and cocaine use on fetal growth. , 1989, The New England journal of medicine.

[17]  R. Behrman,et al.  The impact of cocaine and marijuana use on low birth weight and preterm birth: a multicenter study. , 1995, American journal of obstetrics and gynecology.

[18]  S. Retzky,et al.  Cocaine abuse during pregnancy: peripartum prevalence and perinatal outcome. , 1989, American journal of obstetrics and gynecology.

[19]  R. Kliegman,et al.  Relation of maternal cocaine use to the risks of prematurity and low birth weight. , 1994, The Journal of pediatrics.

[20]  L. Goldschmidt,et al.  Growth of Infants Prenatally Exposed to Cocaine/Crack: Comparison of a Prenatal Care and a No Prenatal Care Sample , 1999, Pediatrics.

[21]  J Grabowski,et al.  Cessation of cocaine use during pregnancy: effects of contingency management interventions on maintaining abstinence and complying with prenatal care. , 1998, Addictive behaviors.

[22]  R. Kliegman,et al.  Direct and indirect interactions of cocaine with childbirth outcomes. , 1994, Archives of pediatrics & adolescent medicine.

[23]  G. Koren,et al.  Maternal and neonatal characteristics following exposure to cocaine in Toronto. , 1993, Reproductive toxicology.

[24]  M. Behnke,et al.  Prenatal cocaine use: a comparison of neonates matched on maternal risk factors. , 1994, Neurotoxicology and teratology.

[25]  D. Bateman,et al.  The effects of intrauterine cocaine exposure in newborns. , 1993, American journal of public health.

[26]  P. Shah,et al.  Induced termination of pregnancy and low birthweight and preterm birth: a systematic review and meta‐analyses , 2009, BJOG : an international journal of obstetrics and gynaecology.

[27]  I. Olkin,et al.  Meta-analysis of observational studies in epidemiology - A proposal for reporting , 2000 .

[28]  J. Feldman,et al.  The biologic and social consequences of perinatal cocaine use in an inner-city population: results of an anonymous cross-sectional study. , 1991, American journal of obstetrics and gynecology.

[29]  J. Feldman,et al.  A Cohort Study of Alkaloidal Cocaine (“Crack”) in Pregnancy , 1988, Obstetrics and gynecology.

[30]  P. Leppert,et al.  The effect of cocaine abuse on birth weight and gestational age , 1988, Obstetrics and gynecology.

[31]  D. Gromisch,et al.  Teratogenicity of cocaine in humans. , 1987, The Journal of pediatrics.

[32]  D. English,et al.  Maternal cocaine use and low birth weight newborns: a meta-analysis. , 1997, Addiction.

[33]  D. Ogunyemi,et al.  The impact of antenatal cocaine use on maternal characteristics and neonatal outcomes , 2004, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[34]  L. Keith,et al.  Cocaine use during pregnancy: Adverse perinatal outcome , 1987, American journal of obstetrics and gynecology.

[35]  N. Paneth,et al.  Maternal cocaine use during pregnancy and perinatal outcomes. , 1994, Epidemiologic reviews.

[36]  K. Kaltenbach,et al.  Biopsychosocial characteristics and treatment outcomes of pregnant cocaine-dependent women in residential and outpatient substance abuse treatment. , 1999, Journal of psychoactive drugs.

[37]  L. Wright,et al.  Low Birth Weight and Preterm Births: Etiologic Fraction Attributable to Prenatal Drug Exposure , 2005, Journal of Perinatology.

[38]  M. Freda,et al.  Cocaine use during pregnancy and low birth weight: The impact of prenatal care and drug treatment , 1995 .

[39]  A. Hadeed,et al.  Maternal cocaine use during pregnancy: effect on the newborn infant. , 1989, Pediatrics.

[40]  T. Einarson,et al.  Fetal effects of cocaine: an updated meta-analysis. , 2001, Reproductive toxicology.

[41]  D. Durand,et al.  Perinatal outcome of infants exposed to cocaine and/or heroin in utero. , 1989, American journal of diseases of children.

[42]  M. Markowitz,et al.  Intrauterine cocaine, lead, and nicotine exposure and fetal growth. , 1994, American journal of public health.

[43]  S. Kelley,et al.  Birth outcomes, health problems, and neglect with prenatal exposure to cocaine. , 1991, Pediatric nursing.

[44]  G. Richardson,et al.  Maternal and neonatal effects of moderate cocaine use during pregnancy. , 1991, Neurotoxicology and teratology.