Relationship between Self-Reported Maternal Substance Abuse and Adverse Outcomes in the Premature Newborn

Oscar A. Viteri; Hector Mendez-Figueroa; Claudia Pedroza; Mateo G. Leon; Baha M. Sibai; Suneet P. Chauhan

doi:10.1055/s-0035-1563549

American Journal of Perinatology, Table of Contents

Am J Perinatol 2016; 33(02): 165-171
DOI: 10.1055/s-0035-1563549

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Relationship between Self-Reported Maternal Substance Abuse and Adverse Outcomes in the Premature Newborn

Authors

Oscar A. Viteri

¹Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, Texas
Hector Mendez-Figueroa

¹Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, Texas
Claudia Pedroza

²Center for Clinical Research and Evidence-Based Medicine, The University of Texas Health Science Center at Houston, Houston, Texas
Mateo G. Leon

¹Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, Texas
Baha M. Sibai

¹Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, Texas
Suneet P. Chauhan

¹Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, Texas

Abstract

Objective This study aims to compare neonatal and long-term outcomes among preterm newborns from women with reported versus those who did not report substance abuse.

Study Design Secondary analysis of a trial of magnesium sulfate for cerebral palsy prevention. Cases were pregnant women who reported substance abuse, controls were those who denied it. Study outcomes included (1) composite neonatal morbidity, defined as any of the following: Apgar score ≤ 3 at 5 minutes, seizures, culture-proven sepsis, necrotizing enterocolitis grades 2 or 3, intraventricular hemorrhage grades 3 or 4, and/or death before discharge; (2) infant and childhood morbidity, defined as stillbirth or death by 1 year, or moderate/severe cerebral palsy by age of 2.

Results Among 1,972 women meeting the inclusion criteria, 197 (10%) reported substance abuse. Composite neonatal, infant, and childhood morbidity rates were similar between cases and controls. However, women reporting substance abuse who delivered between 32^0/7 and 36^6/7 weeks had a higher frequency of composite infant and childhood morbidity (6.5 vs. 1.0%; adjusted odds ratio, 6.5; 95% confidence interval, 1.14–36.99).

Conclusions Preterm birth was associated with similar composite neonatal morbidity between cases and controls. After 32 weeks, self-reported substance abuse was associated with a sevenfold increase in the rates of stillbirth and long-term infant morbidity.

Keywords

cocaine - marijuana - opioids - preterm birth

Full Text

References

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