Low birth weight and preterm births: Etiologic fraction attributable to prenatal drug exposure
OBJECTIVES: To determine the factors that would increase the likelihood of outcomes: low birth weight (LBW), preterm births and intrauterine growth restriction (IUGR).
STUDY DESIGN: Secondary data analysis from a multi-center study. Risk factors for each outcome were derived from logistic regression models. Odds ratios (OR), 95% confidence intervals, and population-attributable risk proportions (PAR%) were estimated.
RESULTS: Prenatal cocaine exposure increased the likelihood of LBW (OR: 3.59), prematurity (OR: 1.25), and IUGR (OR: 2.24). Tobacco, but not marijuana, significantly influenced these outcomes. Alcohol had an effect on LBW and IUGR. Etiologic fractions (PAR%) attributable to tobacco for LBW, prematurity, and IUGR were 5.57, 3.66, and 13.79%, respectively. With additional drug exposure including cocaine, estimated summary PAR% increased to 7.20% (LBW), 5.68% (prematurity), and 17.96% (IUGR).
CONCLUSION: Disease burden for each outcome increases with each added drug exposure; however, etiologic fraction attributable to tobacco is greater than for cocaine.
Bada, HS., Das, A., Bauer, CR., Shankaran, S., Lester, BM., Gard, C., ... Higgins, R. (2005). Low birth weight and preterm births: Etiologic fraction attributable to prenatal drug exposure. Journal of Perinatology, 25(10), 631-637. DOI: 10.1038/sj.jp.7211378