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Mortality Risk Associated with Perinatal Drug and Alcohol Use in California

Journal of Perinatology volume 25, pages 93–100 (2005)Cite this article

Abstract

OBJECTIVE:

To analyze the relationship between perinatal drug/alcohol use and maternal, fetal, neonatal, and postneonatal mortality.

STUDY DESIGN:

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.

RESULTS:

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.

CONCLUSIONS:

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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Acknowledgements

Support was provided by Jan Morgan and Beate Danielsen from the California Office of Statewide Health Planning and Development. This study was also funded by the California Policy Research Center, the National Institute on Drug Abuse San Francisco Treatment Research Center (Center Grant P50 DA09253), and Treatment on Demand Grant (R01 DA12221).

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Authors and Affiliations

  1. Family Health Care Nursing, University of California, San Francisco, San Francisco General Hospital, San Francisco, CA, USA

    Ellen L Wolfe DrPH, PNP

  2. Institute for Health Policy Studies, University of California, San Francisco, CA, USA

    Thomas Davis BA

  3. Medicine and Policy, University of California, San Francisco, CA, USA

    Joseph Guydish PhD, MPH

  4. Department of Psychiatry, University of California, San Francisco, CA, USA

    Kevin L Delucchi PhD

Authors
  1. Ellen L Wolfe DrPH, PNP
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  2. Thomas Davis BA
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  3. Joseph Guydish PhD, MPH
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  4. Kevin L Delucchi PhD
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Corresponding author

Correspondence to Ellen L Wolfe DrPH, PNP.

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Wolfe, E., Davis, T., Guydish, J. et al. Mortality Risk Associated with Perinatal Drug and Alcohol Use in California. J Perinatol 25, 93–100 (2005). https://doi.org/10.1038/sj.jp.7211214

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