Mortality Risk Associated with Perinatal Drug and Alcohol Use in California

Family Health Care Nursing (E.L.W.), University of California, San Francisco, San Francisco General Hospital, San Francisco, CA 94110, USA.
Journal of Perinatology (Impact Factor: 2.07). 03/2005; 25(2):93-100. DOI: 10.1038/
Source: PubMed


To analyze the relationship between perinatal drug/alcohol use and maternal, fetal, neonatal, and postneonatal mortality.
Linked California discharge, birth and death certificate data from 1991-1998 were used to identify drug/alcohol-diagnosed births. Mortality relative risk (RR) ratios were calculated and logistic models were generated for mortality outcomes.
Among 4,536,701 birth records, 1.20% contained drug/alcohol discharge diagnostic codes (n=54,290). The unadjusted RRs for maternal (RR=2.7), fetal (RR=1.3), neonatal (RR=2.4), and postneonatal (RR=4.3) mortality were increased for drug/alcohol-diagnosed births. After controlling for potential confounding, the odds of maternal death for cocaine use (OR=2.15) remained significant as did amphetamine (OR=1.77), cocaine (OR=1.43), polydrug (OR=2.01) and other drug/alcohol use (OR=1.79) for postneonatal mortality.
The association of cocaine use with maternal mortality and any drug/alcohol use with postneonatal mortality supports screening and identifying women using illicit drugs and alcohol during pregnancy. Increased collaboration with drug treatment programs and closer follow-up for drug-using women and their children may improve mortality outcomes.

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    • "Access to reproductive health services, including contraceptives, prenatal care and mothering services [4], are a basic human right [5,6], and are particularly important for marginalized, drug-using women who may experience higher rates of maternal morbidity, mortality and negative obstetric, fetal and child outcomes as a result of drug use during pregnancy [7-10]. While research about access to reproductive health services among drug-using FSWs is scarce, a number of studies report that substance-using mothers experience limited or no access to prenatal care because of the stigma attached to maternal substance use during pregnancy [11-13]. "
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    BMC Pregnancy and Childbirth 08/2011; 11(1):61. DOI:10.1186/1471-2393-11-61 · 2.19 Impact Factor
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    ABSTRACT: To determine the prevalence of psychiatric disorders during pregnancy, the prevalence of cocaine and marijuana use during the third trimester of gestation and the socio-demographic characteristics of a population of low-income teenagers. One thousand pregnant teenagers were evaluated using the Composite International Diagnostic Interview, and a socio-demographic and socio-economic questionnaire at the obstetric center of a public hospital in São Paulo, Brazil. Hair sample was collected for analysis. Of the 1000 pregnant teenagers interviewed, 53.6% were poor, 90.4% were unemployed, 92.5% were financially dependent and 60.2% dropped out of school. Those using drugs during the third trimester of pregnancy were equal to 6% (marijuana: 4%, cocaine: 1.7%, both: 0.3%). Those having at least one psychiatric disorder equaled 27.6%. The most frequent diagnoses were depression (12.9%), posttraumatic stress disorder (10.0%) and anxiety disorders (5.6%). Unstructured families, dropping out of school, unemployment and a low level of professional training are all contributing factors to the maintenance of an unfavorable socio-economic environment in which there is a high prevalence of cocaine and marijuana use during the third trimester of pregnancy and an abnormally high incidence of psychiatric disorders.
    Revista Brasileira de Psiquiatria 07/2006; 28(2):122-5. DOI:10.1590/S1516-44462006000200009 · 1.77 Impact Factor
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