Health Care and Hospitalizations of Young Children Born to Cocaine-Using Women
Archives of Pediatrics & Adolescent Medicine
Objectives: To examine the health care and hospitalizations of young children (birth to age 2 years) born to cocaine-using women and to assess the extent to which premature births account for differences between these children and comparison children. Design: A retrospective cohort design using a repeatmatching method: comparison children were matched to subjects with exposure to cocaine on 6 sociodemographic variables, first, without attention to gestational age and then using the gestational
... ng the gestational age as an additional matching variable. Setting: City hospitals and primary care clinics. Subjects: Children of women giving birth at a single hospital. Main Outcome Measures: Hospital admissions and indexes of health care use for children from birth to age 2 years. Results: Of the 139 subjects with exposure to cocaine, 23% were born prematurely compared with only 6% in the first comparison (PϽ.001). At birth, children with exposure to cocaine remained in the hospital longer (PϽ.01), but this difference was explained by the increased prevalence of prematurity. By age 2 years, these children had significantly fewer visits for health care maintenance (PϽ.001), were less likely to have completed immunizations (PϽ.05), and spent more days in the hospital than comparison children. These differences were not related to prematurity, but were explained by differences in sociodemographic characteristics. Conclusion: Although prematurity is the major reason for lengthier hospital stays at birth of children with exposure to cocaine, adverse social factors contribute most to inadequate preventive health care and increased stays in the hospital in subsequent years. Arch Pediatr Adolesc Med. 1998;152:177-184 Editor's Note: Perhaps we should develop a managed caring system in which there would be a limitation on the number of days allowed for anyone to live in terrible social situations. Do you think that we'd have any buyers?