Cocaine use in pregnancy increased in Northern California since 2011


January 4, 2023

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Disclosure:
Young-Wolff reports receiving a grant from the National Institute on Drug Abuse while conducting research. See research for relevant financial disclosures of all other authors.


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One study found that cocaine use during pregnancy increased in the Northern California health care system compared to the US population level increase from 2011 to 2019. JAMA network open.

However, self-reported rates of prenatal methamphetamine use decreased, and toxicology-confirmed rates remained stable during the study period.

Data obtained from Young-Wolff KC et al. JAMA net open2022; doi:10.1001/jamanetworkopen.2022.48055.

“Cocaine use and methamphetamine use during pregnancy can have both short-term and long-term health effects.” Dr. Kelly C. Young-Wolfe, M.P.H., A licensed clinical psychologist and research scientist and colleagues from Kaiser Permanente Northern California’s research division in Oakland, California, wrote. Epidemiological studies do not include biochemical validation.”

Young-Wolff et al. conducted a cross-sectional analysis of pregnant patients who entered the health care system for prenatal care from 2011 to 2019. They were screened for cocaine and methamphetamine use by physical examination.

In total, 326,051 pregnancies were included in the analysis. The largest proportion of patients were non-Hispanic Caucasians (37.1%) and aged between 25 and 34 years (62.8%).

The adjusted prevalence of cocaine use during pregnancy increased from 0.1% (95% CI, 0.07–0.13) to 0.15% (95% CI, 0.12–0.18) from 2011 to 2019, with relative rates increasing annually. 9% (annual RR = 1.09; 95% CI, 1.05–1.12). Yearly relative rates were greater for toxicologically confirmed cocaine use and self-reported cocaine use (yearly RR = 1.13; 95% CI, 1.09-1.18 vs. yearly RR = 1.06; 95% CI, 1.02 -1.1).

The adjusted prevalence of methamphetamine use during pregnancy decreased from 0.19% (95% CI, 0.14-0.23) to 0.17% (95% CI, 0.14-0.21) during the study period. This was an annual relative rate of 0.97 (95% CI, 0.95-1). Evaluation of annual relative rates by screening type showed that toxicologically confirmed use remained stable (annual RR = 0.99; 95% CI, 0.96–1.03) and self-reported use decreased (annual RR = 0.96; 95% CI, 0.93-0.99). From 2011 to 2019.

“Different trends in prenatal cocaine and methamphetamine use indicate the importance of relevance to early prenatal screening for various types of illicit stimulant use, assessment of substance use disorders, and non-punitive treatment, as appropriate. “Studies show that stopping stimulant use during pregnancy improves birth outcomes,” Young-Wolff and colleagues write. Continued research is needed to understand the factors associated with the use of different types of stimulants.”



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