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Drug abuse during pregnancy increases risk of preterm birth

08 Feb 2019

Women who report drug abuse or dependence during pregnancy are at heightened risk of delivering preterm babies, a study has found.

Researchers explored the risk of preterm birth (PTB; <37 weeks) and early-term birth (37–38 weeks) in a cohort of 2,890,555 women with singleton livebirths. A total of 198,518 women (6.9 percent) delivered prematurely and 77,917 (26.9 percent) delivered at early term. Majority of women in the population were white (74.8 percent) and between 18 and 34 years of age at delivery (79.4 percent).

There were 48,133 (1.7 percent) women who reported drug abuse/dependence (opioid, cocaine, cannabis, amphetamine, other or polysubstance). Nearly 3 percent of these women delivered before 32 weeks of gestation as opposed to 0.9 percent of women without reported drug use (controls; adjusted relative risk [aRR], 1.8; 95 percent CI, 1.7–2.0). On the other hand, 13.3 percent delivered between 32 and 36 weeks of gestation vs 5.8 percent of controls (aRR, 1.6; 1.5–1.6).

Preterm birth (<37 weeks) occurred in 16.2 percent of women with reported drug abuse/dependence vs <7 percent of controls (aRR, 1.6; 1.5–1.6). The incidence varied by drug classification, ranging from 11.6 percent for cannabis users to 24.3 percent for cocaine users (aRRs, 1.1–1.9).

Women with reported drug abuse/dependence, with the exception of cannabis users, were also at slightly increased risk of having early term birth (aRRs, 1.1–1.2). Less than 50 percent of cocaine or amphetamine users delivered between 39 and 42 weeks gestation, while 66.4 percent of nondrug controls delivered during this time period.

According to researchers, the present data may assist clinicians in improving outcomes for pregnant drug users with addiction and their infants. Adequate prenatal care could reduce the impact of drug use on preterm birth.

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