Risk of fetal death associated with maternal drug dependence and placental abruption: a population-based study
Abstract
Objective Substance use in pregnancy is associated with placental abruption, but the risk of fetal death independent of abruption remains undetermined. Our objective was to examine the effect of maternal drug dependence on placental abruption and on fetal death in association with abruption and independent of it.Methods To examine placental abruption and fetal death, we performed a retrospective population-based study of 1 854 463 consecutive deliveries of liveborn and stillborn infants occurring between January 1, 1995 and March 31, 2001, using the Canadian Institute for Health Information Discharge Abstract Database.Results Maternal drug dependence was associated with a tripling of the risk of placental abruption in singleton pregnancies (adjusted odds ratio [OR] 3.1; 95% confidence intervals [CI] 2.6-3.7), but not in multiple gestations (adjusted OR 0.88; 95% CI 0.12-6.4). Maternal drug dependence was associated with an increased risk of fetal death independent of abruption (adjusted OR 1.6: 95% CI 1.1-2.2) in singleton pregnancies, but not in multiples. Risk of fetal death was increased with placental abruption in both singleton and multiple gestations, even after controlling for drug dependence (adjusted OR 11.4 in singleton pregnancy; 95% CI 10.6-12.2, and 3.4 in multiple pregnancy; 95% CI 2.4-4.9).Conclusion Maternal drug use is associated with an increased risk of intrauterine fetal death independent of placental abruption. In singleton pregnancies, maternal drug dependence is associated with an increased risk of placental abruption.
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The risk of abruption is increased among pregnant people who consume illicit drugs, particularly cocaine and marijuana.
“The risk of abruption is also increased among pregnant people who consume illicit drugs, particularly cocaine and marijuana (43, 44).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [43]
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- Authors
- McDonald, S. D., Vermeulen, M. J., & Ray, J. G.
- Affiliations
- McMaster University (CA)
- Institute for Clinical Evaluative Sciences (CA)
- St. Michael's Hospital (CA)
- Venue
- Journal of Obstetrics and Gynaecology Canada
- Publisher
- Elsevier BV
- Published
- 2007-07
- Volume
- 29
- Issue
- 7
- Pages
- 556-559
- ISSN
- 1701-2163 (ISSN-L)
- OpenAlex
- W2146446472
- Cited by
- 31
- References
- 9
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 1 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 2 · 2014: 1 · 2013: 1 · 2012: 3
- FWCI
- 0.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Obstetrics and Gynaecology Canada (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- maternal drug dependence, placental abruption, fetal death, stillbirth, substance use in pregnancy, singleton pregnancy, multiple pregnancy, pregnancy outcomes
- MeSH terms
- Abruptio Placentae, Adult, Female, Fetal Death, Humans, Pregnancy, Pregnancy Complications, Retrospective Studies, Risk Factors, Substance-Related Disorders
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