Low birth weight and preterm births: Etiologic fraction attributable to prenatal drug exposure

Henrietta S. Bada, Abhik Das, Charles R. Bauer, Seetha Shankaran, Barry M. Lester, Charlotte C. Gard, Linda L. Wright, Linda LaGasse, Rosemary Higgins

Research output: Contribution to journalArticlepeer-review

183 Scopus citations


Objectives: To determine the factors that would increase the likelihood of outcomes: low birth weight (LBW), preterm births and intrauterine growth restriction (IUGR). Study design: Secondary data analysis from a multi-center study. Risk factors for each outcome were derived from logistic regression models. Odds ratios (OR), 95% confidence intervals, and population-attributable risk proportions (PAR%) were estimated. Results: Prenatal cocaine exposure increased the likelihood of LBW (OR: 3.59), prematurity (OR: 1.25), and IUGR (OR: 2.24). Tobacco, but not marijuana, significantly influenced these outcomes. Alcohol had an effect on LBW and IUGR. Etiologic fractions (PAR%) attributable to tobacco for LBW, prematurity, and IUGR were 5.57, 3.66, and 13.79%, respectively. With additional drug exposure including cocaine, estimated summary PAR% increased to 7.20% (LBW), 5.68% (prematurity), and 17.96% (IUGR). Conclusion: Disease burden for each outcome increases with each added drug exposure; however, etiologic fraction attributable to tobacco is greater than for cocaine.

Original languageEnglish
Pages (from-to)631-637
Number of pages7
JournalJournal of Perinatology
Issue number10
StatePublished - Oct 2005

Bibliographical note

Funding Information:
The study was carried out with support from NIH National Institute of Child Health and Human Development through cooperative agreements and interagency agreement with the National Institute on Drug Abuse (NIDA), Administration on Children, Youth and Families (ACYF), and Center for Substance Abuse Treatment (CSAT). Participating Institutions, grant awards, investigators, and key research personnel include: Brown University, U10 HD 27904, N01-HD-2-3159 (Barry M. Lester, PhD; Susan Schibler, RN; Melissa Ambrosia, RN; Linda LaGasse, PhD); University of Miami, U10 HD 21397 (Charles R. Bauer, MD; Wendy Griffin, RN; Elizabeth Jacque, RN); University of Tennessee, U10 HD 21415 (Henrietta S. Bada, MD; Marilyn Williams, MSW; Tina Hudson, BSN), Wayne State University, U10 HD 21385 (Seetha Shankaran, MD; Eunice Woldt, MSN, Jay Ann Nelson, BSN), RTI, International, U01 HD 36790 (W. Kenneth Poole, PhD; Abhik Das, PhD; Jane Hammond, PhD); NICHD (Linda L. Wright, MD; Rosemary Higgins, MD) and NIDA (Vincent L. Smeriglio, PhD).

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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