The Maternal Lifestyle Study: Drug exposure during pregnancy and short-term maternal outcomes
The Maternal Lifestyle Study: Drug exposure during pregnancy and short-term maternal outcomes
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DOI：
10.1067/mob.2002.121073
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发表时间：
2002-03-01
影响因子：
9.8
通讯作者：
Verter, J
中科院分区：
文献类型：
--
作者：
Bauer, CR;Shankaran, S;Verter, J
目的：孕期药物暴露对母体产生影响的报道并不一致。母亲生活方式研究(MLS)是一项多中心、前瞻性、观察性研究，旨在更好地确定怀孕期间接触非法药物对母亲、胎儿和婴儿的影响。方法：从1993年5月到1995年5月，在四个临床中心(布朗大学、迈阿密大学、田纳西大学、孟菲斯大学和韦恩州立大学)对19,079名母婴进行了分娩后可卡因和阿片类药物暴露的筛查，其中16,988人(89%)符合资格标准，11,811人(70%)同意参与研究。暴露的定义是允许使用可卡因或鸦片类药物或两者兼用，或通过气相色谱-质谱分析确定胎粪中存在可卡因或鸦片类代谢物。通过访谈和阴性免疫分析筛查，未接触者被定义为阴性药物使用史。结果：在同意参加调查的母亲中，50%是非洲裔美国人，38%已婚，%接受过医疗补助，95%至少做过一次产前检查(中位数10次)。接触可卡因-阿片类药物(n=1185)和未接触可卡因-阿片类药物(n=7442)的母亲之间的显著差异(P<；.01)包括种族(非裔美国人：分别为74.6%和47.0%)、平均年龄(分别为29.6岁和26.1岁)以及使用多种药物，包括酒精、烟草和/或大麻的任何组合(分别为93%和42%)。优势比(99%CI)显示暴露于危险中的母亲显著更高(P
OBJECTIVE: Reports of maternal effects resulting from drug exposure during pregnancy are inconsistent. The Maternal Lifestyle Study (MLS) is a multicenter, prospective, observational study that was initiated to better define the effects of exposure to illicit drugs during pregnancy on the mother, fetus, and infant.METHODS: Between May 1993 and May 1995, of 19,079 mother-infant dyads that were screened after delivery for cocaine and opiate exposure at four clinical centers (Brown University, University of Miami, University of Tennessee, Memphis, and Wayne State University), 16,988 (89%) met eligibility criteria and 11,811 (70%) of those eligible agreed to participate in the study. Exposure was defined as an admission of use of cocaine or opiates or both or the presence of cocaine or opiate metabolites in meconium as determined by use of gas chromatography-mass spectroscopy assay. Nonexposure was defined as a negative drug use history by interview and a negative immunoassay screen. When exposure could not be confirmed, such as when meconium was not obtained or was inadequate for confirmatory analysis, the mother-infant dyad was excluded (n = 3184).RESULTS: Of the mothers who consented to participate, 50% were African American, 38% were married, 64% were Medicaid recipients, and 95% had at least one prenatal care visit (median, 10 visits). Significant differences (P < .01) between cocaine-opiate exposed (n = 1185) and nonexposed (n = 7442) mothers included race (African American: 74.6% and 47.0%, respectively), mean age (29.6 and 26.1 years, respectively), and polydrug use including any combination of alcohol, tobacco, and/or marijuana (93% and 42%, respectively). Odds ratios (99% Cl) indicate that exposed mothers had a significantly higher risk(P