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Health-care Utilization among Mothers and Infants Following Cocaine Exposure

Journal of Perinatology volume 23, pages 361–367 (2003)Cite this article

Abstract

OBJECTIVE: To examine utilization of health-care resources among mothers and infants following cocaine use during pregnancy.

DESIGN:Prospective observational study.

SETTING:Four clinical sites.

PATIENTS/METHODS: Medical and social services resource use was examined among 8514 mother–infant dyads, 1072 of whom used cocaine and 7442 who did not. Use was stratified by <1500 g and >1500 g birth-weight strata to differentiate the low birth weight from the larger weight group adjusting for site, infant gender, and maternal race and education.

OUTCOME MEASURES:Resource use evaluated among mothers included prenatal care, hospitalizations, medications and mode of delivery. Resource use for infants included therapies, procedures and length of stay.

RESULTS: Fewer cocaine-exposed women, compared to those in the nonexposed group, had prenatal care or used medications during pregnancy in both <1500 g category 0.10 (0.04 to 0.22) (OR (99% CI) and 0.26 (0.10 to 0.65), respectively, and in the >1500 g category 0.14 (0.11 to 0.19) and 0.61 (0.49 to 0.74), respectively. Length of hospital stay for social reasons and referrals to child protective services were increased in cocaine-exposed infants in both <1500 g category 66.8 (4.38 to 999.9) and 77.4 (17.64 to 289.13), respectively and in the >1500 g category 70.74 (41.73 to 119.94) and 125.88 (81.78 to 193.77), respectively. In addition, among >1500 g cocaine-exposed infants, length of stay in neonatal intensive care unit was increased 1.53 (1.16 to 2.02) as was therapies 1.76 (1.45 to 2.13), procedures 1.50 (1.23 to 1.83), need for formula feeds 5.45 (2.28 to 13.02) and intravenous fluids 1.50 (1.19 to 1.87),

CONCLUSION: Cocaine exposure has no deleterious or protective effects on medical resource needs of <1500 g infants or their mothers. Resource needs reflect those of morbidity of being born premature. The increase in health-care resources for >1500 g cocaine-exposed infants for surveillance and monitoring in the absence of an increase in congenital anomalies should be discouraged.

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Authors and Affiliations

  1. Wayne State University, Detroit, MI, USA

    Seetha Shankaran MD

  2. University of Miami, Miami, FL, USA

    Charles R Bauer MD

  3. University of Tennessee at Memphis, Memphis, Tennessee, USA

    Henrietta S Bada MD

  4. Women and Infants Hospital, Providence, RI, USA

    Barry Lester PhD

  5. National Institute of Child Health and Human Development, USA

    Linda L Wright MD

  6. Research Triangle Institute, Research Triangle Park, NC, USA

    Abhik Das PhD

Authors
  1. Seetha Shankaran MD
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  2. Charles R Bauer MD
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  3. Henrietta S Bada MD
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  4. Barry Lester PhD
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  5. Linda L Wright MD
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  6. Abhik Das PhD
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Additional information

This study was supported by the National Institute of Child Health and Human Development through cooperative agreements (U10 HD 21385) (S.S.), (U10 HD 21397)(C.R.B.), (U10 HD 27856) (H.S.B.), (U10 HD 27904) (B.L.), (U01 HD 36790) (A.D.).

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Shankaran, S., Bauer, C., Bada, H. et al. Health-care Utilization among Mothers and Infants Following Cocaine Exposure. J Perinatol 23, 361–367 (2003). https://doi.org/10.1038/sj.jp.7210946

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