Drug use or inadequate prenatal care? Adverse pregnancy outcome in an urban setting.

Abstract

This study analyzed the relationships between illicit drug use, low birth weight, adequacy of prenatal care, and perinatal mortality. Perinatal outcome parameters in 23,926 deliveries between 1983 and 1990 were analyzed. Statistical analysis (chi 2 analysis) was applied for each year of study to separate the effects of inadequate prenatal care from illicit drug use. Patients with drug use had a two to three times higher incidence of low birth weight and perinatal death. Drug use with more than five prenatal visits had a minimal effect on outcome; drug use with inadequate care was associated with a three times higher incidence of perinatal death and low birth weight. Adequacy of prenatal care is a marker of "social chaos" and affects outcome more than drug use itself.