Cocaine and tobacco use and the risk of spontaneous abortion
Cocaine and tobacco use and the risk of spontaneous abortion
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DOI：
10.1056/nejm199902043400501
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发表时间：
1999-02-04
影响因子：
158.5
通讯作者：
Kline, J
中科院分区：
文献类型：
--
作者：
Ness, RB;Grisso, JA;Kline, J
背景吸烟和可卡因的使用可能是自然流产的危险因素，但支持这种联系的数据是limited.Methods我们研究了可卡因和烟草的使用和自然流产之间的关联在怀孕的青少年和妇女（年龄范围，14至40岁）谁寻求照顾在内城急诊科。共有400名青少年和女性在进入研究时或在随访期间（持续至妊娠22周）发生自然流产，570名青少年和女性在妊娠22周后仍妊娠。通过自我报告和尿液和头发样本的分析来测量基线的可卡因使用，通过自我报告和尿液分析来测量吸烟。结果两组中的青少年和女性主要是黑人，社会经济地位较低。在那些有自然流产的人中，28.9%的人根据头发分析使用可卡因，34.6%的人根据尿液可替宁分析吸烟，而没有自然流产的青少年和妇女分别为20.5%和21.8%。在调整人口统计学和药物使用变量后，头发样本中可卡因的存在与自然流产发生率的增加独立相关（比值比，1.4; 95%置信区间，1.0至2.1）。然而，通过自我报告和尿液分析测量的可卡因使用情况却没有。尿液中可替宁的存在也与自然流产风险增加独立相关（比值比，1.8; 95%置信区间，1.3至2.6）。24%的自然流产风险可能与可卡因或烟草使用有关。结论可卡因使用和烟草使用在我们的研究人群中很常见，并且与自然流产的显著风险相关，（N Engl J Med 1999;340：333-9）。(C)1999年，马萨诸塞州医学会。
Background Cigarette smoking and cocaine use may be risk factors for spontaneous abortion, but data supporting such a link are limited.Methods We studied the associations between cocaine and tobacco use and spontaneous abortion among pregnant adolescents and women (age range, 14 to 40 years) who sought care at an inner-city emergency department. A total of 400 adolescents and women had spontaneous abortions either at study entry or during follow-up (which lasted until 22 weeks' gestation), and 570 adolescents and women remained pregnant past 22 weeks' gestation. Cocaine use was measured at base line by self-reports and analysis of urine and hair samples, Cigarette smoking was measured by self-reports and urine analysis.Results The adolescents and women in both groups were predominantly black and of lower socioeconomic status. Among those who had spontaneous abortions, 28.9 percent used cocaine on the basis of hair analysis and 34.6 percent smoked on the basis of a urine cotinine assay, as compared with 20.5 percent and 21.8 percent, respectively, of the adolescents and women who did not have spontaneous abortions. The presence of cocaine in hair samples was independently associated with an increase in the occurrence of spontaneous abortion (odds ratio, 1.4; 95 percent confidence interval, 1.0 to 2.1) after adjustment for demographic and drug-use variables. However, the use of cocaine as measured by self-reports and by urine analysis was not. The presence of cotinine in urine was also independently associated with an increased risk of spontaneous abortion (odds ratio, 1.8; 95 percent confidence interval, 1.3 to 2.6). Twenty-four percent of the risk of spontaneous abortion could be related to cocaine or tobacco use.Conclusions Cocaine use and tobacco use were common in our study population and were associated with a significant risk of spontaneous abortion, (N Engl J Med 1999;340:333-9.) (C) 1999, Massachusetts Medical Society.