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Cocaine, marijuana use during pregnancy harmful to fetus.


Pregnant women who use cocaine or marijuana are more likely to give birth to infants with lower birth weight, decreased length, or smaller head circumference, says a study funded by the National Institute on Drug Abuse (NIDA). The investigators also found that the histories given by these women did not accurately reflect drug use.

Researchers interviewed more than 1200 pregnant Boston women during a three-year period beginning in 1984. The women were given a urine test to determine the amount of cocaine and marijuana in their bodies. Based on these samples (as well as a few confessions from the mothers-to-be), the investigators found that 27 percent of the women used marijuana during their pregnancies and 18 percent used cocaine. Urine tests alone revealed 16 percent were marijuana users and 9 percent used cocaine. Compared with infants whose mothers' urine tests revealed no drug use, infants whose mothers tested positive for marijuana use weighed on the average nearly three ounces less and were nearly a quarter-inch shorter in length. Babies whose mothers tested positive for cocaine use weighed an average 3.3 ounces less than babies whose mothers did not test positive for drugs. The cocaine babies were also nearly a half-inch shorter on the average and had nearly a quarter-inch smaller average head circumference. The research team noted that a smaller head circumference "may indicate a smaller brain."

The researchers found that more than 100 of the women in the study reported no drug use in preliminary interviews. Once tested, however, these women were found to have traces of the drugs in them. This fact alone, the researchers conclude, "underscores the importance of using a biologic marker to accurately identify drug use during pregnancy and the potential errors that could result from reliance on self-reports of drug use." The investigators admit, however, that their study took no consideration of the effects of other substances, such as cigarette smoking and alcohol consumption, both of which have also been shown to adversely affect fetal development. "Future studies should attempt to identify substance use by employing biologic markers for all substances [that might be] used by pregnant women." (New England Journal of Medicine, March 23, 1989; 320:762-768.)
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Publication:Medical Update
Date:May 1, 1989
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