RECENT COCAINE USE IS NOT ASSOCIATED WITH FETAL ACIDEMIA OR OTHER MANIFESTATIONS OF INTRAPARTUM FETAL DISTRESS

ABSTRACT

The objective of this paper is to evaluate the impact of recent cocaine use on umbilical cord blood gas values in cocaine-dependent pregnant women who received formal prenatal care. Ninety-two cocaine-dependent pregnant women receiving comprehensive prenatal care were divided into two groups, with patients in Group A (n = 35) testing positive for cocaine metabolites at the time of delivery and Group B (n = 57) testing negative. One hundred and three patients with no history of drug or alcohol dependence served as the control group (Group C). Umbilical cord blood gases were obtained at all deliveries. Additional variables included 1 and 5-min Apgar scores, meconium staining of the amniotic fluid, route of delivery, premature rupture of the membranes, and length of nursery stay. There were no statistically significant differences between groups in either umbilical artery pH, pO₂, pCO₂, bicarbonate, or base excess. Similarly, there was no difference in meconium staining of the amniotic fluid, depressed Apgar scores, cesarean delivery, or neonatal length of stay. Our data do not support an association between recent cocaine use and fetal hypoxemia or acidemia, depressed 5-min Apgar scores, meconium staining of the amniotic fluid, or cesarean delivery in cocaine-dependent pregnant women enrolled in prenatal care.

KEYWORD

Cocaine - prenatal care - pregnancy - umbilical blood gases

REFERENCES

• 1 Hadeed A J, Siegel S R. Maternal cocaine use during pregnancy: effect on the newborn infant.  Pediatrics . 1989;  84 205-210
• 2 Mastrogiannis D S, Decavalas G O, Verma U, Tejani N. Perinatal outcome after recent cocaine usage.  Obstet Gynecol . 1990;  76 8-11
• 3 Ostrea E M, Kresbach P, Knapp D K, Simkoowski K. Abnormal heart rate tracings and serum creatinine phosphokinase in addicted neonates.  Neurotoxicol Teratol . 1987;  9 305-309
• 4 Gillogley K M, Evans A T, Hansen R L, Samuels S J, Batra K K. The perinatal impact of cocaine, amphetamine and opiate use detected by universal intrapartum screening.  Am J Obstet Gynecol . 1990;  163 1535-1542
• 5 Oro A S, Dixon S D. Perinatal cocaine and methamphetamine exposure: maternal and neonatal correlates.  J Pediatr . 1987;  111 571-578
• 6 MacGregor S N, Keith L G, Chasnoff I J. Cocaine use during pregnancy: adverse perinatal outcome.  Am J Obstet Gynecol . 1987;  157 686-690
• 7 Neerhoff M G, MacGregor S N, Retzky S S, Sullivan T P. Cocaine abuse during pregnancy: peripartum surveillance and perinatal outcome.  Am J Obstet Gynecol . 1989;  161 633-638
• 8 Little B B, Snell L M, Klein R, Gilstrap L C. Cocaine abuse during pregnancy: maternal and fetal implications.  Obstet Gynecol . 1989;  73 157-160
• 9 Spence M R, Williams R, DiGregorio G J, Kirby-McDonnel A, Polansky M. The relationship between recent cocaine use and pregnancy outcome.  Obstet Gynecol . 1991;  78 326-329
• 10 Calhoun B C, Watson P T. The cost of maternal cocaine abuse: I. Perinatal cost.  Obstet Gynecol . 1991;  78 731-734
• 11 McCalla S, Minkoff H L, Feldman J. The biologic and social consequences of perinatal cocaine use in an inner-city population: results of an anonymous cross-sectional study.  Am J Obstet Gynecol . 1991;  164 625-630
• 12 Dombrowski M P, Wolfe H M, Welch R A. Cocaine use is associated with abruptio placentae and decreased birth weight but not shorter labor.  Obstet Gynecol . 1991;  77 139-141
• 13 Moore T R, Sorg J, Miller L, Key T C, Resnik R. Hemodynamic effects of intravenous cocaine on the pregnant ewe and fetus.  Am J Obstet Gynecol . 1986;  155 889-893
• 14 Woods J R, Plessinger M A, Clark K E. Effects of cocaine on uterine blood flow and oxygenation.  JAMA . 1987;  257 957-961
• 15 Morgan M A, Silavin S L, Randolph M. Effect of intravenous cocaine on uterine blood flow in the gravid baboon.  Am J Obstet Gynecol . 1991;  164 1030-1032
• 16 Hamilton H E, Wallace J E, Shimek E L. Cocaine and benzylecognine excretion in humans.  J Forensic Sci . 1977;  22 697-707
• 17 Andres R L, Larrabee K, Elk R. Prenatal care and patterns of drug use: relative contributions to perinatal outcome in cocaine dependent pregnant women.  Journal of the Society for Gynecologic Investigation . 1996;  3 272A
• 18 Broekhuizen F F, Utrie J, Van Mullem C. Drug use or inadequate prenatal care?.  <~>Adverse pregnancy outcome in an urban setting. Am J Obstet Gynecol . 1992;  166 1747-17541