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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

2018; Springer Science+Business Media; Volume: 298; Issue: 3 Linguagem: Inglês

10.1007/s00404-018-4833-2

1432-0711

Jucilene Freitas dos Santos, Cibelle de Melo Bastos Cavalcante, Fabiano Timbó Barbosa, Daniel Leite Góes Gitaí, Marcelo Duzzioni, Cristiane Queixa Tilelli, Ashok K. Shetty, Olagide Wagner de Castro,

Neuroscience of respiration and sleep

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. 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. 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). 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.