A Cohort Study of Alkaloidal Cocaine (“Crack”) in Pregnancy
A Cohort Study of Alkaloidal Cocaine (“Crack”) in Pregnancy
复制标题
妊娠期生物碱可卡因（“快克”）的队列研究
作者：
Radha Cherukuri;H. Minkoff;J. Feldman;A. Parekh;L. Glass
最近，对可卡因（“快克”）的使用急剧增加，引起了人们对怀孕期间使用可卡因可能对胎儿产生有害影响的关注。快克不会被加热破坏，可以吸烟，并将大量可卡因输送到肺的血管床，产生类似于静脉注射的效果。为了描述快克使用与妊娠结局的关系，我们对55名承认在妊娠期间使用快克的妇女和55名在同一时期分娩的非吸毒妇女进行了一项回顾性配对队列研究。各组在年龄、产次、社会经济地位、饮酒情况以及是否有产前护理方面进行了匹配。使用快克的妇女在37周或更早分娩的人数明显更多（50.9%对16.4%; P = 0.001）。接触可卡因的婴儿发生宫内发育迟缓的可能性是对照组的3.6倍（P <0.006），头围小于胎龄第10百分位数的可能性是对照组的2.8倍（P <0.007）。破裂组胎膜早破的发生率是对照组的1.8倍（P <0.03）. 60%的使用快克的母亲没有得到产前护理。少数婴儿存在异常神经行为症状，通常是轻度的。（妇产科72：147，1988）
The recent dramatic increase in the use of alkaloidal cocaine (“crack”) has led to concern about possible deleterious fetal effects associated with its use during pregnancy. Crack, which is not destroyed by heating, can be smoked, and delivers a large quantity of cocaine to the vascular bed of the lung, producing an effect similar to that from intravenous injection. To describe the association of crack use with pregnancy outcome, we conducted a retrospective matched cohort study of 55 women who admitted to the use of crack during pregnancy and 55 non-drug-using women who delivered during the same period. The groups were matched for age, parity, socioeconomic status, alcohol use, and presence or absence of prenatal care. A significantly larger number of women using crack delivered at 37 weeks or earlier (50.9 versus 16.4%; P =.001). Crack-exposed infants were 3.6 times more likely to have intrauterine growth retardation (P <.006) and 2.8 times more likely to have a head circumference less than the tenth percentile for gestational age (P <.007). Premature rupture of the membranes was 1.8 times more common in the crack group (P <.03). Sixty percent of crack-using mothers received no prenatal care. Abnormal neurobehavioral symptoms were present in a minority of infants and were usually mild. (Obstet Gynecol 72:147, 1988)