PURPOSE: The aim of the study was to assess perinatal outcome of pregnancy burdened with maternal addiction in comparison with an unselected population from a European transition country. MATERIALS AND METHODS: Data on pregnancies complicated by illicit drug abuse (n = 85) managed during a 10-year period (1997-2007) at Split University Hospital were analyzed. Data on the type of drug, course of gestation and labor, and on perinatal outcome were considered. Data on all non-dependence pregnancies recorded during the study period were used as a control group. RESULTS: During the study period, there were 85 dependence-complicated pregnancies (0.2%). Use of heroin alone during pregnancy was recorded in 51 women (50%), methadone alone in 6 (7%), and a combination of heroin and methadone in 9 (11%). Premature delivery was significantly more common in the group of pregnant addicts (21% vs. 6%); 49% of pregnant addicts were carriers of hepatitis C virus (HCV) and 14% of hepatitis B virus (HBV). Neonatal abstinence syndrome developed in 61 infants (7%) born to addicted mothers. There were 4 cases (4.6%) of early neonatal death; 7 neonates had 5-minute Apgar score < or = 7 (8%); 29 neonates had low birth weight for age (33%); and 7 neonates had congenital anomalies (8%). The risk of various congenital anomalies was 3-fold in the group of children born to addicted mothers. CONCLUSION: Addiction pregnancies present a small but high-risk group according to perinatal outcome. Appropriate obstetric and neonatal care can reduce the rate of complications in these pregnancies and improve perinatal outcome.
Adult ; Apgar Score ; Birth Weight ; Croatia/epidemiology ; Female ; Heroin/adverse effects ; Heroin Dependence/*complications/drug therapy/epidemiology ; Humans ; Incidence ; Infant Mortality ; Infant, Newborn ; *Maternal Exposure ; Methadone/adverse effects/therapeutic use ; Neonatal Abstinence Syndrome/epidemiology ; Pregnancy ; Pregnancy Complications/*chemically induced/epidemiology ; Pregnancy Complications, Infectious/epidemiology ; *Pregnancy Outcome

OBJECTIVETo investigate the association between ambient fine particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) and the risk on preterm birth.

METHODSA total of 1 882 pregnant women with local residency of Taiyuan city and underwent delivery at the First Hospital of Shanxi Medical University with the dates of conception between January 1 and December 31, 2013, were enrolled in the study. Information on general demographics, home address and history on pregnancy, lifestyle and related environmental factors were collected through in-person interview. Birth outcomes and maternal complications were abstracted from medical records. Data on the amount of daily average PM2.5 from 8 monitor points in Taiyuan city, between March 1, 2012 and December 31, 2013 were also collected. Individual exposure during pregnancy were calculated using the inverse-distance weighting method, based on home address. Multivariate unconditional logistic regression model was used to examine the associations among PM2.5 exposure, risk of preterm birth and related clinical subtypes.

RESULTSThe overall incidence of preterm birth was 8.21% (151/1 839)in 1 839 pregnant women. Exposure to ambient PM2.5 during the second week prior to delivery was associated with an increased risk of preterm birth (OR=1.087, 95% CI: 1.001-1.182 per 10 μg/m(3) increase) and mild preterm birth (OR=1.099, 95% CI: 1.007-1.200 per 10 μg/m(3)). Compared to data from the China Environmental Air Quality Standard, higher level of exposure (≥75 μg/m(3)) of PM2.5 during the second week before delivery was associated with an increased risk of preterm birth (OR=1.008, 95%CI: 1.000-1.017) but the association was mainly seen for mild preterm birth (OR=1.010, 95%CI: 1.001-1.018).

CONCLUSIONSRESULTS from our study showed that exposure to high level of PM2.5 during late pregnancy would increase the risk of preterm birth. Future large studies are needed to examine the association by preterm clinical subtypes and to elucidate potential underlying mechanisms.

China ; epidemiology ; Environmental Exposure ; adverse effects ; analysis ; Female ; Humans ; Incidence ; Infant, Newborn ; Logistic Models ; Maternal Exposure ; Particle Size ; Particulate Matter ; analysis ; toxicity ; Pregnancy ; Pregnancy Complications ; Premature Birth ; chemically induced ; epidemiology ; Public Health ; statistics & numerical data