Cocaine abuse during pregnancy: peripartum prevalence and perinatal outcome.

The frequency of cocaine abuse during pregnancy has increased markedly in recent years. Cocaine abuse during pregnancy has been associated with significant perinatal morbidity and mortality. In this study a large population of pregnant women were tested for drug use at the time of their admission to the hospital for labor and delivery. During the study period a total of 138 (8%) of 1776 patients who were delivered of infants had positive urine toxicologic screening tests for cocaine. Moreover, the prevalence of peripartum cocaine abuse increased considerably during the study period. The perinatal outcomes of the 138 patients whose urine samples yielded positive test results for cocaine were compared with those of the 88 control patients with negative results. Cocaine use was associated with lower gestational age at delivery and higher incidences of preterm delivery, premature rupture of the membranes, and small-for-gestational-age infants. When compared with control infants, infants of mothers who used cocaine had more instances of neonatal morbidity and longer hospitalizations. In this study peripartum cocaine abuse was common, increased during the study period, and was associated with perinatal morbidity.