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INTRAUTERINE GROWTH RESTRICTION |
Obstet Gynecol. 2002 Nov;100(5 Pt 1):916-24.
Gestational cocaine exposure and intrauterine growth: maternal lifestyle
study.
Bada HS, Das A, Bauer CR, Shankaran S, Lester B, Wright LL, Verter J,
Smeriglio VL, Finnegan LP, Maza PL.
The University of Kentucky, Lexington, Kentucky 40536, USA. hbada@uky.edu
Objectives:
To estimate the effects of cocaine exposure on intrauterine
growth and to investigate at what point in gestation growth deviation would
be manifested.
Methods:
This is a secondary analysis of data from a
multicenter project, the Maternal Lifestyle Study, designed to determine
infant outcomes of in utero cocaine or opiates exposure. Four centers of the
National Institute of Child Health and Human Development Neonatal Research
Network enrolled 11,811 maternal-infant dyads. A total of 1072 infants were
cocaine exposed, 7565 were cocaine negative by maternal history and meconium
results, and 3174 were excluded from analysis because of unconfirmed
negative exposure. Outcome measures included birth weight, length, and head
circumference.
Results:
Percentile estimates for birth weight, length, and
head circumference revealed growth deceleration in cocaine-exposed infants
evident after 32 weeks' gestation. There was significant interaction between
cocaine and gestational age. After controlling for confounders, at 40 weeks'
gestation, cocaine exposure was estimated to be associated with a decrease
of 151 g, 0.71 cm, and 0.43 cm in birth weight, length, and head
circumference, respectively. Smoking had a negative impact on all growth
measurements, with some indication of a dose-effect relationship. Heavy
alcohol use was associated with decrease in weight and length only. Opiates
had significant effect only on birth weight.
Conclusion:
In utero cocaine
exposure is associated with growth deceleration involving all measurements,
becoming more pronounced with advancing gestation.
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