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J Perinatol. 2005 Feb;25(2):93-100.

Mortality risk associated with perinatal drug and alcohol use in California.

Author information

1
Family Health Care Nursing (E.L.W.), University of California, San Francisco, San Francisco General Hospital, San Francisco, CA 94110, USA. ewolfe@sfghpeds.ucsf.edu

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.

PMID:
15496968
PMCID:
PMC3349286
DOI:
10.1038/sj.jp.7211214
[Indexed for MEDLINE]
Free PMC Article

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