Reports of maternal/infant toxicity due to drug exposure during pregnancy are inconsistent. A large, collaborative, prospective, observational study(MLS) was initiated to better define exposure effects. Between May, 1993 and May, 1995, of 19,079 maternal/infant dyads screened for cocaine/opiate (C/O) exposure at four clinical centers (Brown U, U of Miami, U of Tenn, Memphis and Wayne State U), 16,982 (85%) met eligibility criteria and 11,810 (62%) agreed to participate. Exposure (EXP) was defined as an admission of C/O use or the presence of C/O metabolites in meconium using a central GC/MS assay. Of the consenting mothers, 50% were black, 60% were single, and 61% were Medicaid recipients. In this high risk cohort, 93% had at least one prenatal care visit(median-10 visits). Significant (p < 0.01) differences between EXP(n = 1185)and /non-C/O exposed(NON) (n = 10,625) mothers included:Table
Odds ratios (OR)[±95% confidence limits]) indicate that EXP mothers had significantly more (p < 0.001) medical conditions such as syphilis 6.8[5.6-8.4], gonorrhea 2.3[1.7-3.2], chronic psychotic/nervous disorders 2.5[1.7-3.8] and abruptio placenta 2.1[1.5-3.1]. HIV testing (available on 28% of the cohort) was positive more often in the EXP group 5.9[3.9-9.0]. Overall, seventeen cases of AIDS were identified. The number of re-hospitalizations was not different, but of the 10% hospitalized at least once, etiologies involving violence were more common in the EXP group 13.5[5.6-32.6]. Although EXP mothers had more medical conditions, the overall prevalence of complications in this large high-risk population was remarkably low.