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September 18, 1991, Vol 266, No. 11 >
ARTICLE | September 18, 1991

Drugs, Alcohol, Pregnancy, and the Neonate: Title and subTitle BreakPay Now or Pay Later FREE

Ira J. Chasnoff, MD
[+] Author Affiliations

Reprint requests to National Association for Perinatal Addiction Research Education, 11 E Hubbard St, Suite 200, Chicago, IL 60611 (Dr Chasnoff).


JAMA. 1991;266(11):1567-1568. doi:10.1001/jama.1991.03470110113044
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References

As a premed student in undergraduate school, I struggled through the economics courses required for graduation, comforting myself with the thought that economics has nothing to do with health care. Twenty-five years later, I have come to recognize the delusion under which I was working. The article by Phibbs et al1 in this issue of JAMA confirms what many practitioners have long suspected: maternal drug use, especially the use of crack cocaine, is driving the cost of care for the exposed infants beyond any reasonable level.

From a national perspective, the total cost implications of drug and alcohol, and especially cocaine, use during pregnancy elude us, primarily because we really do not know how many exposed infants are being born each year. The earliest study looking at this issue found that 11% of infants born in 36 selected hospitals across the country had

REFERENCES

1 +
Phibbs CS, Bateman DA, Schwartz RM.  The neonatal costs of maternal cocaine use. JAMA . 1991;;266:1521-1526.
2 +
Chasnoff IJ.  Drug use and women: establishing a standard of care. Ann N Y Acad Sci . 1989;;562:208-210.
3 +
Chasnoff IJ, Landress HJ, Barrett ME.  The prevalence of illicit drug or alcohol use during pregnancy and discrepancies in mandatory reporting in Pinellas County, Florida. N Engl J Med . 1990;;322:1202-1206.
4 +
Centers for Disease Control. Current trends: statewide prevalence of illicit drug use by pregnant women—Rhode Island. MMWR . 1990;;39:225-227.
5 +
National Household Survey on Drug Abuse: Population Estimates 1990 . Rockville, Md: National Institute on Drug Abuse; 1991;. US Dept of Health and Human Services publication 91-1732.
6 +
Gomby DS, Shiono PH.  Estimating the number of substance-exposed infants. Future Child . 1991;;1:17-25.
7 +
Ostrea EM, Brady M, Gause S, Stevens M, Raymundo AL, Baker G.  High prevalence of drug abuse in an obstetric population as detected by analysis of infants' stools (meconium) for drugs. Pediatr Res . 1990;;27:251A.
8 +
Zuckerman B, Frank DA, Hingson R, et al.  Effects of maternal marijuana and cocaine use on fetal growth. N Engl J Med . 1989;;320:762-768.
9 +
Abel EL, Sokol RJ.  Incidence of fetal alcohol syndrome and economic impact of FAS-related anomalies. Drug Alcohol Depend . 1987;;19:51-70.
10 +
Kleinman JC, Kopstein A.  Smoking during pregnancy, 1967-80. Am J Public Health . 1987;;77:823-825.
11 +
 The need for treatment.  In: Gerstein DR, Harwood HJ, eds. Treating Drug Problems . Washington, DC: National Academy Press; 1990;:85.
12 +
Manning WG, Keeler EB, Newhouse JP, Sloss EM, Wasserman J.  The taxes of sin: do smokers pay their way? JAMA . 1989;;262:901.
13 +
General Accounting Office.Drug-Exposed Infants: A Generation at Risk . Washington, DC: US General Accounting Office; 1990;. Publication GAO/HRD-90-138.
14 +
Chasnoff IJ, Griffith DR, MacGregor S, Dirkes K, Burna KA.  Temporal patterns of cocaine use in pregnancy. JAMA . 1989;;261:1741-1744.
15 +
Little BB, Snell LM, Klein V, Gelstrap LC.  Cocaine abuse during pregnancy: maternal and fetal implications. J Obst Gynecol . 1989;;73:157-160.
16 +
Chasnoff IJ, Griffith DR, Freier C, Murray J.  Cocaine/polydrug use in pregnancy: two year follow-up. Pediatrics . In press.
17 +
Little RE, Young A, Streissguth AO, Ukl CN. Preventing Fetal Alcohol Effects: Effectiveness of a Demonstration Project . Marshfield, Mass: Pitman Publishers Inc; 1984;.
18 +
Brown SS, ed. Prenatal Care: Reaching Mothers, Reaching Infants . Washington, DC: National Academy Press; 1988;.
19 +
Office of the State Comptroller.A Preliminary Analysis of the Impact of Prenatal Exposure to Crack in New York City . New York: State of New York; 1991;.
20 +
Canova D. Survey on State Alcohol and Drug Agency Use of FY 1989 Federal and State Funds . Washington, DC: National Association of State Alcohol and Drug Abuse Directors; 1990;.
21 +
Hearings Before the Committee on Children, Youth and Families. US House of Representatives (1991) (testimony of G. O'Neill).

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Phibbs CS, Bateman DA, Schwartz RM.  The neonatal costs of maternal cocaine use. JAMA . 1991;;266:1521-1526.
2 +
Chasnoff IJ.  Drug use and women: establishing a standard of care. Ann N Y Acad Sci . 1989;;562:208-210.
3 +
Chasnoff IJ, Landress HJ, Barrett ME.  The prevalence of illicit drug or alcohol use during pregnancy and discrepancies in mandatory reporting in Pinellas County, Florida. N Engl J Med . 1990;;322:1202-1206.
4 +
Centers for Disease Control. Current trends: statewide prevalence of illicit drug use by pregnant women—Rhode Island. MMWR . 1990;;39:225-227.
5 +
National Household Survey on Drug Abuse: Population Estimates 1990 . Rockville, Md: National Institute on Drug Abuse; 1991;. US Dept of Health and Human Services publication 91-1732.
6 +
Gomby DS, Shiono PH.  Estimating the number of substance-exposed infants. Future Child . 1991;;1:17-25.
7 +
Ostrea EM, Brady M, Gause S, Stevens M, Raymundo AL, Baker G.  High prevalence of drug abuse in an obstetric population as detected by analysis of infants' stools (meconium) for drugs. Pediatr Res . 1990;;27:251A.
8 +
Zuckerman B, Frank DA, Hingson R, et al.  Effects of maternal marijuana and cocaine use on fetal growth. N Engl J Med . 1989;;320:762-768.
9 +
Abel EL, Sokol RJ.  Incidence of fetal alcohol syndrome and economic impact of FAS-related anomalies. Drug Alcohol Depend . 1987;;19:51-70.
10 +
Kleinman JC, Kopstein A.  Smoking during pregnancy, 1967-80. Am J Public Health . 1987;;77:823-825.
11 +
 The need for treatment.  In: Gerstein DR, Harwood HJ, eds. Treating Drug Problems . Washington, DC: National Academy Press; 1990;:85.
12 +
Manning WG, Keeler EB, Newhouse JP, Sloss EM, Wasserman J.  The taxes of sin: do smokers pay their way? JAMA . 1989;;262:901.
13 +
General Accounting Office.Drug-Exposed Infants: A Generation at Risk . Washington, DC: US General Accounting Office; 1990;. Publication GAO/HRD-90-138.
14 +
Chasnoff IJ, Griffith DR, MacGregor S, Dirkes K, Burna KA.  Temporal patterns of cocaine use in pregnancy. JAMA . 1989;;261:1741-1744.
15 +
Little BB, Snell LM, Klein V, Gelstrap LC.  Cocaine abuse during pregnancy: maternal and fetal implications. J Obst Gynecol . 1989;;73:157-160.
16 +
Chasnoff IJ, Griffith DR, Freier C, Murray J.  Cocaine/polydrug use in pregnancy: two year follow-up. Pediatrics . In press.
17 +
Little RE, Young A, Streissguth AO, Ukl CN. Preventing Fetal Alcohol Effects: Effectiveness of a Demonstration Project . Marshfield, Mass: Pitman Publishers Inc; 1984;.
18 +
Brown SS, ed. Prenatal Care: Reaching Mothers, Reaching Infants . Washington, DC: National Academy Press; 1988;.
19 +
Office of the State Comptroller.A Preliminary Analysis of the Impact of Prenatal Exposure to Crack in New York City . New York: State of New York; 1991;.
20 +
Canova D. Survey on State Alcohol and Drug Agency Use of FY 1989 Federal and State Funds . Washington, DC: National Association of State Alcohol and Drug Abuse Directors; 1990;.
21 +
Hearings Before the Committee on Children, Youth and Families. US House of Representatives (1991) (testimony of G. O'Neill).

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