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APHA Scientific Session and Event Listing

Jessie Gerteis, BA¹, Vijay Ramalingam, BS², Brett Martin, MS³, Howard Cabral, PhD¹, and Deborah A. Frank, MD⁴. (1) School of Public Health, Boston University, 725 Mass Ave., Mezz SW, Boston, MA 02118, 617-414-7048, jgerteis@bu.edu, (2) School of Medicine, Boston University, 725 Mass Ave., Mezz, SW, Boston, MA 02118, (3) Data Coordinating Center, Boston University, 580 Harrison Ave, 2nd Fl., Boston, MA 02118, (4) Department of Pediatrics, Boston Medical Center, 725 Massachusetts Ave., Mezz, SW, Boston, MA 02118

Previous research (Ostrea, 1997) has found that cocaine exposed infants do not have increased mortality in the first 2 years of life. Their mothers' mortality rate, however, has not previously been described. We ascertained the death rate in the decade following birth for 252 urban, low-income women [mean age at index birth 26.4 (+/- 5.1 years), 84% African-American, 90% single] who did and did not use cocaine during the index pregnancy. Women were recruited immediately post-partum between 1990-1993. Exclusion criteria included use of illicit drugs other than cocaine or marijuana, preterm delivery, HIV+ infant, and need for NICU care. Deaths were ascertained through 2003 via searches of the Social Security Death Index and the National Death Index. The overall crude death rate in this sample is 2.8%(7 of 252) [1.8% (2/ 113) of the non-users and 3.6% (5/ 139) of the users]. Compared to non-users, relative risk of death among cocaine using mothers is 2.06 (95% C.I. 0.41, 15.33). The non-users experienced a death rate of 1.47 per 1,000 person-years of follow-up, while the users experienced a death rate of 3.03 per 1,000 person-years. All of the mothers who died were African American. Although the difference in mortality rates between the cocaine using and non-using mothers does not meet the criteria for statistical significance for this small sample, the number of cocaine using mothers who delivered healthy, full-term babies but died in the subsequent decade is striking. Close medical follow-up for the mother-child dyad is indicated.

Learning Objectives:

• Describe the long term mortality risk for women who deliver infants with intrauterine cocaine exposure.

Keywords: African American, Women's Health

Presenting author's disclosure statement:

Not Answered