Cocaine abuse in pregnancy: effects on the fetus and newborn

FRANÇAIS :
Etude faite sur 150 femmes enceintes: le premier groupe de 5à femmes consomme héroïne, méthadone plus cocaïne, le deuxième utilise héroïne et méthadone sans cocaïne, dans le troisième groupe les femmes ne sont pas toxicomanes. L'âge moyen est identique dans les trois groupes. En ce qui concerne les avortements spontanés et les morts foetales, on n'en trouve que dans les groupes de toxicomanes. Dans ces deux groupes on a isolé 21 symptômes caractérisant l'état de dépendance des nouveau-nés: on n'a noté aucune différence entre les deux groupes. Par ailleurs il a été trouvé une différence significative en ce qui concerne le poids de naissance, le périmètre crânien et le score d'Agarqui est plus faible chez les femmes cocaïnomanes que chez les non toxicomanes. [Résumé Toxibase]
ENGLISH:
The outcome of infants born to cocaine-using drug dependent women was compared to that of infants of non-cocaine using drug dependent and non-drug dependent women. The study population included 150 pregnant women: 50 women used heroin and methadone plus cocaine, 50 used heroin and methadone minus cocaine, and 50 were non-drug dependent women. Significant differences were found between the cocaine and drug-free groups in infant birth weight, length, head circumference and Apgar scores, with the cocaine group having lower values for each variable. Average gestational age did not vary between the 3 groups. The cocaine group included 1 spontaneous abortion and 4 fetal deaths; non-cocaine drug dependent women had 2 fetal deaths, with none in the control group. Mean abstinence scores for 19 of the physiological and behavioral parameters were lower in the cocaine group than in the non-cocaine drug dependent women with the exception of vomiting and convulsions. These data suggest that: (1) infants born to drug dependent women have a poorer general outcome than those born to non-drug dependent women; (2) maternal cocaine use does not appear to increase the incidence of severe neonatal abstinence symptomatology; (3) pregnancies complicated by cocaine abuse have a greater chance for fetal loss resulting from both spontaneous abortions and fetal death; (4) infants born to cocaine abusing women had infants with decreased birth weight, head circumference, length and Apgar scores.