Document Detail

Relationship between gestational cocaine use and pregnancy outcome: a meta-analysis.
MedLine Citation:
PMID:  1835806     Owner:  NLM     Status:  MEDLINE    
Despite a growing number of studies that have investigated the reproductive effects of maternal cocaine use, a homogeneous pattern of fetal effects has not been established and there is little consensus on the adverse effects of the drug. We used meta-analysis to evaluate the reproductive risks of cocaine. We reviewed the 45 scientific papers published in the English language dealing with effects of cocaine used during pregnancy on pregnancy outcome in humans, and identified 20 papers eligible for meta-analysis (cocaine use in pregnancy, pregnancy/fetal outcome studies, human studies, original work, cohort or case control studies, control group present, English language). Our analysis revealed that very few adverse reproductive effects could be shown to be significantly associated with cocaine use by polydrug users when compared to control groups of polydrug users not using cocaine [genitourinary malformations; odds ratio of 6.08 (95% CI 1.18-31.3); gestation age: Cohen's d 0.37 (CI 0.2-0.55)]. When the control groups consisted of no drug users, the polydrug users abusing cocaine had a higher risk for spontaneous abortions [odds ration 10.50 (CI 11.74-64.1)]. Similarly, comparison of users of cocaine alone or no drug users revealed a higher risk for in utero death, in addition to genitourinary tract malformations. Analysis of continuous variables (head circumference, gestational age, birth weight and length) revealed that the effect size was dependent upon the nature of the comparison. Comparison of cocaine users to no drug users consistently yielded a medium effect size (Cohen's d) between 0.50 and 0.58, while comparison of polydrug/cocaine users to polydrug/no cocaine users provided effect sizes small to non existent (0.06-0.37). These discrepancies suggest that a variety of adverse reproductive effects commonly quoted to be associated with maternal use of cocaine may be caused by confounding factors clustering in cocaine users.
B Lutiger; K Graham; T R Einarson; G Koren
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Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Teratology     Volume:  44     ISSN:  0040-3709     ISO Abbreviation:  Teratology     Publication Date:  1991 Oct 
Date Detail:
Created Date:  1992-01-03     Completed Date:  1992-01-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0153257     Medline TA:  Teratology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  405-14     Citation Subset:  IM    
Department of Pediatrics, Hospital for Sick Children Toronto, Ontario, Canada.
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MeSH Terms
Abortion, Spontaneous
Infant, Low Birth Weight
Infant, Newborn
Meta-Analysis as Topic
Pregnancy Complications / epidemiology*,  etiology
Pregnancy Outcome
Reference Values
Substance-Related Disorders*
Sudden Infant Death
Reg. No./Substance:

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

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