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Relationships of Serum Illicit Drug Concentrations During Pregnancy to Maternal Nutritional Status¹

Enid M. Knight², Hutchinson James, Cecile H. Edwards, Bernice G. Spurlock^*,3, Ura Jean Oyemade^*, Allan A. Johnson, William L. West, O. Jackson Cole^*, Lennox S. Westney^**, Ouida E. Westney^*, Malcolm Manning, Haziel Laryea^* and Sidney Jones

Departments of Nutritional Sciences ^* Human Development Pharmacology ^** Obstetrics & Gynecology ^* Nutrition Program Project, Howard University D.C. General Hospital and Howard University Hospital, Washington, D.C. 20059

Findings reported are for a subset of African American subjects, residing in the urban area of Washington, D. C., who participated in a Program Project designed to study nutrition, other factors, and the outcome of pregnancy. Fasting blood samples, drawn during each trimester of pregnancy and at delivery, were screened for concentrations of cocaine, phencyclidine (PCP) and marijuana. Since substance abusers are expected to consume inadequate diets, these samples were also analyzed for serum folate, vitamin B₁₂, ferritin and ascorbic acid. Data for these biochemical variables were compared for subjects whose serum values for drugs were either above or below the drug screening threshold concentrations established by ADAMHA/NIDA. Pearson's correlations were used to determine relationships between pregnancy outcome variables and maternal serum drug concentrations. Blood samples drawn at delivery showed higher maternal: cord ratios (mean ± SEM) for marijuana (3.3 ± 2.2) and PCP (2.9 ± 1.0) than for cocaine (1.0 ± 0.2). The subjects whose serum values were above the ADAMHA/NIDA ranges for marijuana, PCP and cocaine had concentrations of folate and ferritin that were significantly less than those of subjects with lower serum drug levels (P 0.05). High maternal serum concentrations of illicit drugs were accompanied by a significant increase in leukocyte count (P 0.05). The level of maternal cocaine during the third trimester was inversely correlated with birthweight (r = -0.29; n = 52; P = 0.038) and head circumference (r = -0.28; n = 52; P = 0.047). The reduction in maternal serum folate and ferritin in women with high blood concentrations of marijuana, PCP and cocaine suggests that illicit drug use within this subset of pregnant women might affect maternal nutritional status. The inverse correlation of maternal levels of cocaine with birthweight and head circumference, and illicit drugs with ferritin and folate values observed in this population are worthy of further investigation.

KEY WORDS: • illicit drugs • serum folate • ferritin • infant birth weight • head circumference

¹ The investigations reported in this paper were made as part of the program project "Nutrition, Other Factors and the Outcome of Pregnancy," supported by the National Institute of Child Health and Human Development, National Institutes of Health, through a grant in 1985 to the Department of Human Nutrition and Food, School of Human Ecology, Howard University. Guest Editor for this supplement volume to The Journal of Nutrition was Cecile H. Edwards, Department of Nutritional Sciences, College of Allied Health Sciences, Howard University, Washington, D. C. 20059. Tapes of the data are available at cost by sending a written request to the Guest Editor at the above address. Supported by Grant 3 PO1 HD17104-05, ENG, NICHD, NIH.

² To whom all correspondences should be addressed.

³ Current address is Biology Department, Jackson State University, Jackson, MS 39217.