Document Detail


Health-care utilization among mothers and infants following cocaine exposure.
MedLine Citation:
PMID:  12847529     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine utilization of health-care resources among mothers and infants following cocaine use during pregnancy. DESIGN: Prospective observational study. SETTING: Four clinical sites. PATIENTS/METHODS: Medical and social services resource use was examined among 8514 mother-infant dyads, 1072 of whom used cocaine and 7442 who did not. Use was stratified by <1500 g and >1500 g birth-weight strata to differentiate the low birth weight from the larger weight group adjusting for site, infant gender, and maternal race and education. OUTCOME MEASURES: Resource use evaluated among mothers included prenatal care, hospitalizations, medications and mode of delivery. Resource use for infants included therapies, procedures and length of stay. RESULTS: Fewer cocaine-exposed women, compared to those in the nonexposed group, had prenatal care or used medications during pregnancy in both <1500 g category 0.10 (0.04 to 0.22) (OR (99% CI) and 0.26 (0.10 to 0.65), respectively, and in the >1500 g category 0.14 (0.11 to 0.19) and 0.61 (0.49 to 0.74), respectively. Length of hospital stay for social reasons and referrals to child protective services were increased in cocaine-exposed infants in both <1500 g category 66.8 (4.38 to 999.9) and 77.4 (17.64 to 289.13), respectively and in the >1500 g category 70.74 (41.73 to 119.94) and 125.88 (81.78 to 193.77), respectively. In addition, among >1500 g cocaine-exposed infants, length of stay in neonatal intensive care unit was increased 1.53 (1.16 to 2.02) as was therapies 1.76 (1.45 to 2.13), procedures 1.50 (1.23 to 1.83), need for formula feeds 5.45 (2.28 to 13.02) and intravenous fluids 1.50 (1.19 to 1.87), CONCLUSION: Cocaine exposure has no deleterious or protective effects on medical resource needs of <1500 g infants or their mothers. Resource needs reflect those of morbidity of being born premature. The increase in health-care resources for >1500 g cocaine-exposed infants for surveillance and monitoring in the absence of an increase in congenital anomalies should be discouraged.
Authors:
Seetha Shankaran; Charles R Bauer; Henrietta S Bada; Barry Lester; Linda L Wright; Abhik Das
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  23     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:    2003 Jul-Aug
Date Detail:
Created Date:  2003-07-08     Completed Date:  2003-09-26     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  361-7     Citation Subset:  IM    
Affiliation:
Wayne State University, Detroit, MI, USA.
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Drug-Induced / diagnosis,  therapy*
Cocaine-Related Disorders / diagnosis,  therapy*
Cohort Studies
Confidence Intervals
Female
Humans
Infant Care / utilization
Infant, Newborn
Intensive Care Units, Neonatal / utilization*
Logistic Models
Male
Multivariate Analysis
Postnatal Care
Pregnancy
Pregnancy Complications*
Pregnancy Outcome
Prenatal Care
Prenatal Exposure Delayed Effects*
Prospective Studies
Risk Assessment
Women's Health Services / utilization*
Grant Support
ID/Acronym/Agency:
U01 HD36790/HD/NICHD NIH HHS; U10 HD 27856/HD/NICHD NIH HHS; U10 HD21385/HD/NICHD NIH HHS; U10 HD21397/HD/NICHD NIH HHS; U10 HD27904/HD/NICHD NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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