Drug use or inadequate prenatal care? Adverse pregnancy outcome in an urban setting.

Objective: This study analyzed the relationships between illicit drug use, low birth weight, adequacy of prenatal care, and perinatal mortality.

Study Design: Perinatal outcome parameters in 23,926 deliveries between 1983 and 1990 were analyzed. Statistical analysis (chi 2 analysis) was applied for each year of study to separate the effects of inadequate prenatal care from illicit drug use.

Results: Patients with drug use had a two to three times higher incidence of low birth weight and perinatal death. Drug use with more than five prenatal visits had a minimal effect on outcome; drug use with inadequate care was associated with a three times higher incidence of perinatal death and low birth weight.

Conclusion: Adequacy of prenatal care is a marker of "social chaos" and affects outcome more than drug use itself.