Risk of preterm birth among women using drugs during pregnancy with elevated α-fetoprotein

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Abstract

OBJECTIVE:

Examine the risk of preterm birth (PTB) among women who use drugs during pregnancy and have elevated α-fetoprotein (AFP).

STUDY DESIGN:

The sample included California singleton live births in 2005 to 2010 contained within a hospital discharge database linked to the Prenatal Screening Program. A selection of mothers who did not use drugs was selected at a ratio of 4:1. Risk of PTB was calculated using adjusted odds ratios and 95% confidence intervals (CIs) for women who did or did not use drugs by their AFP percentile.

RESULTS:

We identified 7190 women who used drugs and selected 28 760 women who did not. Of women using cocaine with AFP ≥95th percentile, 43.8% delivered prematurely. Women using drugs with AFP ≥95th percentile were 11 to 35 times as likely to deliver < 32 weeks.

CONCLUSION:

The combination of drug use and elevated AFP results in high rates of PTB. This combination results in an additive risk.

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