Substance use during pregnancy and perinatal outcomes

Abstract

Introduction:Substance use in pregnancy is an increasingly common problem and become an important public health issue.Objetive:To determine the obstetric and perinatal outcomes of self-reported substance use (licit and illicit drugs) during pregnancy in Spanish women sample.Methods:An observational, longitudinal cohort study of 309 Spanish Caucasian women and her newborn child. Psychiatric disorders during pregnancy and neonatal death were excluded. After written informed consent,women and newborn were evaluated at 2nd-day postpartum. Variables included: socio-demographic, obstetric, mothers'psychiatric condition, self-reported substance use, perinatal outcomes.Results:Sixty-six percent of women reported substance use during pregnancy: 59% caffeine, 26% tobacco, 9% alcohol, and 1% cannabis. Incidence of poor outcomes: Apgar scores <8 at 5 minutes after birth (Apgar5) 9.3% (N=29), gestational age at delivery <37 weeks 4.8% (N=15), birth weight <2.5 kg 7.2%(N=22), congenital malformations 2.9%(N=9). Women with newborn who had Apgar5 <8 have consumed more tobacco (271/124 cigarettes;p=0.004) and caffeine (47/32;p=0.051) in the last month of pregnancy than those with Apgar5 ≥8. Logistic regression analysis showed that the risk of Apgar5 <8 was 18.5 times greater (OR=6.001;95%CI=2.009-170.903) in women with lower educational level comparing with women with higher educational level.Conclusion:The dose of tobacco and caffeine used during the last month of pregnancy are associated with poor outcome (Apgar5<8) in a sample of women of general population.These results need to be tested in a bigger sample.This work has been done in part with Grants: Instituto Carlos III: GO3/184; FIS: PI041783.