Maternal lifestyles study (NILS): Effects of substance exposure during pregnancy on acute maternal outcomes

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 (CIO] exposure at four clinical centers (Brown U. U of Miami, U of Term. Memphis and Wayne State Ul. 16.982 (85%) met eligibBty criteria and 11,810 (62%) agreed to participate. Exposure (EXP) was defined as an admission of C/O use or the presence of C/0 metabolites in meconium using a central GC/MS assay. Of the consenting mothers. 50% were black, 60% were single, end 61% were Medicaid recipients. In this high risk cohort. 93% had at least one prenatal care visit lmedian-10 visits). Significant lp<0.01) differences between EXP[n = 1185)and /non-C/O exposed(NONHn=10,6251 mothers included: Status Race(%Blackl Aoelvral Alcohol Use Tobacco Use Marijuana Use EXP 884(74.6%) 30.1.±.5.1 820(69.2%) 952(80.3%) 439(37.1%) NON 4970146.8%) 26.64±5.8 3214(30.3%) 2097(19.7%) 499(4.7%) Odds ratios (OR)l±95 % confidence limits]) indicate that EXP mothers had signitlcantly more (p < 0.0011 medical conditions such as syphilis 6.815.6-8.4], gonorrhea 2.311.7-3.21, chronic psychotic/nervous disorders 2.511.7-3.81 and abruptio placenta 2.1 [1.5-3.11. HIV testing (available on 28% of the cohort) was positive more often in the EXP group G .9(3.99.01. 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 13.515.6-32.61. Although EXP mothers had more medical conditions, the overall prevelence of complications in this large high-risk population was remarkably low.