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The perinatal impact of cocaine, amphetamine, and opiate use detected by universal intrapartum screening

Article Abstract:

Drug use by pregnant women is associated with a variety of fetal defects, including low birth weight, stillbirth, abruptio placentae (where the placenta rips away from the uterine wall), fetal distress, cerebral infarction (interruption of circulation to the fetal brain), birth defects, toxic and withdrawal reactions, sudden infant death syndrome, and behavioral abnormalities. Although all are known to occur with drug use in the perinatal period (the weeks just preceding delivery), studies have not been able to separate the effects of drugs of abuse from those of smoking, alcohol, poor prenatal care, or poverty, among other factors. Tests of the urinary concentrations of cocaine, amphetamines, and opiates (i.e. narcotics such as heroin) were performed on 1,643 pregnant women who visited an urban perinatal center. The patients were then followed-up to evaluate fetal status, and their pregnancy outcomes were compared with those from a matched control group of 293 patients with negative test results. A positive test result was obtained for 20.5 percent of the women (338 ''study patients''), with cocaine the most commonly used drug (46 percent of positive tests), followed by amphetamine-methamphetamine (35 percent). Differences between study patients and controls were found in age (controls were younger), obstetric history (abortions, number of living children), race (a higher proportion of blacks and a lower proportion of Hispanics and Asians among study patients), smoking (much more prevalent among study patients), prenatal care (study patients had less), and other factors. Study patients had a higher rate of premature labor, but no differences were found between the groups for other complications. Birth weights, lengths, head circumferences and gestational age were lower for study patients than controls. Almost half the women who tested positive said they had not used drugs during pregnancy; thus, simply obtaining a history of drug use is not enough to determine whether a woman is likely to test positive. The study screened all women admitted to the obstetrical service, an approach that can identify chemical use in a large proportion of pregnant women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Complications and side effects, Fetus, Mandatory drug testing, Drug testing, Narcotics, Cocaine, Drug abuse in pregnancy, Amphetamines

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Thrombopoietin in normal pregnancy and preeclampsia

Article Abstract:

Thrombopoietin levels appear to be elevated during pregnancy. This chemical regulates the production of blood platelets, which are involved in the production of blood clots. Researchers measured thrombopoietin levels in 21 healthy pregnant women, 17 healthy non-pregnant women, 8 pregnant women with preeclampsia and 6 with the HELLP syndrome. HELLP syndrome is characterized by low blood platelet levels. Thrombopoietin levels were significantly higher in the healthy pregnant women and the pregnant women with HELLP syndrome compared to the other two groups.

Measurement, Pregnancy, Preeclampsia, Blood platelets

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