Cocaine and Tobacco Use and the Risk of Spontaneous Abortion

• Published in: The New England journal of medicine Vol. 340; no. 5; pp. 333 - 339
• Main Authors: Ness, Roberta B, Grisso, Jeane Ann, Hirschinger, Nancy, Markovic, Nina, Shaw, Leslie M, Day, Nancy L, Kline, Jennie
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 04.02.1999
• Subjects: Abortion; Abortion, Spontaneous - chemically induced; Abortion, Spontaneous - epidemiology; Adolescent; Adult; Biological and medical sciences; Case-Control Studies; Cocaine - adverse effects; Cocaine - analysis; Cocaine - urine; Confounding Factors (Epidemiology); Cotinine - urine; Drug addictions; Female; Hair - chemistry; Humans; Medical sciences; Miscarriage; Multivariate Analysis; Pregnancy; Risk Factors; Smoking - adverse effects; Substance Abuse Detection; Teenagers; Toxicology; Human; Drug addiction; Pregnancy disorders; Toxicity; Spontaneous; Case control study; Risk analysis; Abortion; Cigarette; Ester; Tobacco; Female; Cocaine
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199902043400501

Spontaneous abortion is the most common adverse outcome of pregnancy. 1 Heralded by vaginal bleeding, it is associated with considerable pain, suffering, and medical costs. Little is known about the influences of lifestyle on spontaneous abortion, although the use of illicit drugs has been implicated as a factor. 2 – 4 Cocaine use early in pregnancy decreases uterine and placental blood flow by inhibiting the reuptake of norepinephrine, which causes arterial vasoconstriction. 5 , 6 In rats, exposure to cocaine increases the frequency of reabsorption of fetuses, the equivalent of spontaneous abortion in humans. 7 Nicotine, the main addictive compound of tobacco smoke, is also a . . .