Abstract
The purpose of this study was to identify infant and maternal outcomes associated with self-reported illicit drug use during pregnancy and to determine if illicit drug use prior to pregnancy, but not during pregnancy, conferred added risk to the mother or infant. Participants were identified from newborn referrals to the local visiting nurse association (VNA) and unrestricted birth certificates over a 3-month study period in a city 20 miles southeast of Boston. Of 360 subjects contacted, 284 who had delivered a viable infant agreed to participate. Data were collected using an interview schedule designed for this study and were analyzed using descriptive statistics and logistic regression. Of the 284 subjects, 26.8% of the subjects reported using any illicit drug, 22.5% reported using marijuana, and 10.6% cocaine during pregnancy. Pregnancy users of illicit drugs had a 2.2 (confidence interval [CI] = 1.1, 4.4) greater risk of experiencing premature birth, precipitous labor, low weight gain placental abruption, and/or vaginal bleeding than nonusers. Infants of pregnancy users had a 2.8 (CI = 1.2, 4.3) greater risk of being small for gestational age, having low birth weight, having early gestational age, and/or being shaky or jittery. Use of illicit drugs prior to pregnancy but not during pregnancy was not associated with any poor maternal or infant outcome. Nurses can be instrumental in identifying women who are polydrug users so they can receive appropriate outreach and treatment to assure future low-risk pregnancies.