Date of Award

January 2015

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Kimberly A. Yonkers

Subject Area(s)

Medicine, Mental health

Abstract

Background: Cocaine is the third most commonly used illicit substance in pregnancy. Few studies exist to specifically look for correlates of cocaine use in pregnancy.

Objective: To identify correlates of frequency of cocaine use in pregnancy

Methods: We analyzed retrospective data from 50 postpartum women with a history of cocaine use or dependence who participated in a treatment trial for postpartum cocaine use. Study variables included severity of baseline cocaine use, age of onset of use, comorbid mental illness, poly-substance use, trauma and social support history. Data were analyzed using GLMM Negative Binomial Regression.

Results: The strongest correlate of cocaine use in pregnancy was baseline cocaine use six months prior to pregnancy. Daily or greater cocaine use at baseline was associated with a 2.88 increase in the degree of cocaine use in pregnancy (SD=0.57, p <0.0001) on a scale of 0 to 8 measuring frequency of cocaine use. Weekly or greater cocaine use prior to pregnancy was associated with a 2.58 increase in degree of cocaine use (SD= 0.57, p<0.0001). Positive marijuana use in pregnancy was associated with a 1.24 increase in frequency of cocaine use (SD=0.24, p<0.0001). Older age at onset of cocaine use and higher social support scores were both significant, but weakly associated with increased cocaine use in pregnancy. Comorbid mental illness, alcohol use and trauma history were not statistically significant.

Conclusions: This study identified several correlates of heavier cocaine use in pregnancy, and may help guide clinicians in improving screening and directing resources for education of pregnant, cocaine using women.

Comments

This is an Open Access Thesis.

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