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Maternal, fetal and neonatal consequences associated with the use of crack cocaine during the gestational period: a systematic review and meta-analysis

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Abstract

Objective

Crack cocaine consumption is one of the main public health challenges with a growing number of children intoxicated by crack cocaine during the gestational period. The primary goal is to evaluate the accumulating findings and to provide an updated perspective on this field of research.

Methods

Meta-analyses were performed using the random effects model, odds ratio (OR) for categorical variables and mean difference for continuous variables. Statistical heterogeneity was assessed using the I-squared statistic and risk of bias was assessed using the Newcastle–Ottawa Quality Assessment Scale. Ten studies met eligibility criteria and were used for data extraction.

Results

The crack cocaine use during pregnancy was associated with significantly higher odds of preterm delivery [odds ratio (OR), 2.22; 95% confidence interval (CI), 1.59–3.10], placental displacement (OR, 2.03; 95% CI 1.66–2.48), reduced head circumference (− 1.65 cm; 95% CI − 3.12 to − 0.19), small for gestational age (SGA) (OR, 4.00; 95% CI 1.74–9.18) and low birth weight (LBW) (OR, 2.80; 95% CI 2.39–3.27).

Conclusion

This analysis provides clear evidence that crack cocaine contributes to adverse perinatal outcomes. The exposure of maternal or prenatal crack cocaine is pointedly linked to LBW, preterm delivery, placental displacement and smaller head circumference.

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Authors and Affiliations

  1. Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP 57072-970, Brazil

    Jucilene Freitas dos Santos, Cibelle de Melo Bastos Cavalcante, Fabiano Timbó Barbosa, Daniel Leite Góes Gitaí, Marcelo Duzzioni & Olagide Wagner de Castro

  2. Central-West Campus Dona Lindu, Federal University of São João del-Rei (UFSJ), Divinópolis, MG, Brazil

    Cristiane Queixa Tilelli

  3. Department of Molecular and Cellular Medicine, Institute for Regenerative Medicine, Texas A&M Health Science Center College of Medicine, College Station, TX, USA

    Ashok K. Shetty

Authors
  1. Jucilene Freitas dos Santos
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  2. Cibelle de Melo Bastos Cavalcante
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  3. Fabiano Timbó Barbosa
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  4. Daniel Leite Góes Gitaí
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  5. Marcelo Duzzioni
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  6. Cristiane Queixa Tilelli
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  7. Ashok K. Shetty
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  8. Olagide Wagner de Castro
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Contributions

JFS: data collection, project development, manuscript writing and editing, data administration, data interpretation. CMBC: data collection, project development, manuscript writing and editing, data administration, data interpretation. MD: manuscript editing. DLGG: manuscript editing. CQT: manuscript editing. FTB: project development, data administration, data interpretation, data analysis, statistical analysis. AKS: manuscript editing. OWC: project development, scientific knowledge, data collection, project development manuscript writing and editing.

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Correspondence to Olagide Wagner de Castro.

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Jucilene Freitas dos Santos and Cibelle de Melo Bastos Cavalcante equal participation.

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dos Santos, J.F., de Melo Bastos Cavalcante, C., Barbosa, F.T. et al. Maternal, fetal and neonatal consequences associated with the use of crack cocaine during the gestational period: a systematic review and meta-analysis. Arch Gynecol Obstet 298, 487–503 (2018). https://doi.org/10.1007/s00404-018-4833-2

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  • DOI: https://doi.org/10.1007/s00404-018-4833-2

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