A study of antenatal cocaine use—Chaos in action,

Objective: This study identified behaviors or conditions associated with cocaine use among prenatal patients and evaluated pregnancy outcomes. Study Design: A case-control study of patients attending a neighborhood-based prenatal program was conducted. For each patient who used cocaine, the next prenatal registrant with both a negative history of cocaine use and a negative urine screen for cocaine served as the control. Results: Cocaine use was associated with older, multiparous women who had a history of prior low birth weight infants. Prenatal care was obtained later and less frequently. Other substances, including tobacco, alcohol, and marijuana, were more commonly used. A history of physical abuse and violence, as well as incarceration, was identified more often. The prevalence of syphilis was higher. Women who used cocaine were delivered of their infants earlier; prematurity occurred more often. Their infants were smaller. Regression analysis identified factors other than cocaine as important in either low birth weight or preterm delivery. Attainment of a greater number of prenatal care visits was associated with improved outcome. Conclusion: Women who use cocaine have numerous significant life disturbances, which may collectively influence pregnancy outcome. Cocaine use itself is a marker and did not appear to influence the prevalence of low birth weight or preterm delivery. (Am J Obstet Gynecol 1999;180:1427-31.)