The use of cocaine and crack during pregnancy and its effects on newborns and children: a systematic review protocol

Abstract

Introduction: The use of illicit drugs represents an important public health problem in the world, especially when it comes to developing countries like Brazil. Objective: To evaluate the effects of cocaine exposure in utero on the motor development and mortality in newborns and children. Methods: We will carry out a systematic review including observational studies (cohort or case-control), published in full text or just as an abstract. The study protocol will be registered on the Prospero Platform. We will include newborns and children up to 36 months of age. We will carry out searches in the following databases: Medical Literature Analysis and Retrieval System Online (Medline) via Pubmed, Excerpta Medica dataBASE (Embase) via Elsevier, Cochrane Central Register of Controlled Trials (CENTRAL) via Cochrane Library, Latin American Literature and the Caribbean in Health Sciences (Lilacs) via the Virtual Health Library Portal and Physiotherapy Evidence Database (PEDro), with no restrictions on language or year of publication. We will assess the methodological rigor of the included studies and the certainty of the evidence of the main results of the systematic review using the Cochrane ROBINS-E- Risk of Bias in Non- randomized Studies- of Exposure (ROBINS-E) tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, respectively. Two independent investigators will perform the selection of studies, data extraction, assessment of the risk of bias of included studies and assessment of the certainty of evidence. Expected Results: The results of this review are expected to summarize the best scientific evidence currently available regarding the effects of cocaine and crack use during pregnancy on newborns and children, and provide useful information for clinical decision-making. Furthermore, it is believed that the results of this review may expose knowledge gaps and provide a good foundation for future high-quality studies on the subject.