Impact of substance use during pregnancy on neonatal condition at birth

PREETI SARAN

Advisor: Saba Masho, M.D., Dr.P.H.

Preceptor: Gerges Seifen, M.D., MPH

Background and Objectives: Illicit drug use is the ninth leading contributing cause of death in the United States. The most frequent age of drug use by women is also the age of childbearing causing detrimental effect on infants. This study is designed to determine the effects of drug use on the newborn’s apgar score.

Methods: Data on birth records between January 1- December 31, 2001 was obtained from the Vital Statistics department of the Virginia Department of Health. The data consisted of 101,122 live singleton births in Virginia. The outcome variable, low Apgar score, was defined as the apgar score 6 or less at one and five minute after birth and the exposure variable in this study is self reported drug use. Crude odds ratios were calculated using bivariate analysis and logistic regression was done to adjust for confounding factors.

Results: Strong statistical association was found between drug use and apgar score at one minute 1.7 [95 % CI 1.4-2.2] and five minute and 2.9 [95% CI 1.9-4.4] when crude odds ratios were calculated. However, the association lost its statistical significance when adjusted for potential confounding factors [OR=1.15 [95% CI 0.8-1.5] at one minute and [OR=1.18 [95%CI 0.6-2.1].

Conclusion: This study showed that self-reported maternal drug use during pregnancy has no significant relationship with low apgar scores of infants at both one minute and five minute. It is consistent with findings of other studies. It is important to note that developmental/functional impairments may not be immediately evident following prenatal insult. The potential for long-term deleterious outcomes remains and must be considered through further study. Further study is also recommended on data utilizing more accurate data on drug use.