Archives of Gynecology and Obstetrics

, Volume 298, Issue 3, pp 487–503 | Cite as

Maternal, fetal and neonatal consequences associated with the use of crack cocaine during the gestational period: a systematic review and meta-analysis

  • Jucilene Freitas dos Santos
  • Cibelle de Melo Bastos Cavalcante
  • Fabiano Timbó Barbosa
  • Daniel Leite Góes Gitaí
  • Marcelo Duzzioni
  • Cristiane Queixa Tilelli
  • Ashok K. Shetty
  • Olagide Wagner de CastroEmail author



Crack cocaine consumption is one of the main public health challenges with a growing number of children intoxicated by crack cocaine during the gestational period. The primary goal is to evaluate the accumulating findings and to provide an updated perspective on this field of research.


Meta-analyses were performed using the random effects model, odds ratio (OR) for categorical variables and mean difference for continuous variables. Statistical heterogeneity was assessed using the I-squared statistic and risk of bias was assessed using the Newcastle–Ottawa Quality Assessment Scale. Ten studies met eligibility criteria and were used for data extraction.


The crack cocaine use during pregnancy was associated with significantly higher odds of preterm delivery [odds ratio (OR), 2.22; 95% confidence interval (CI), 1.59–3.10], placental displacement (OR, 2.03; 95% CI 1.66–2.48), reduced head circumference (− 1.65 cm; 95% CI − 3.12 to − 0.19), small for gestational age (SGA) (OR, 4.00; 95% CI 1.74–9.18) and low birth weight (LBW) (OR, 2.80; 95% CI 2.39–3.27).


This analysis provides clear evidence that crack cocaine contributes to adverse perinatal outcomes. The exposure of maternal or prenatal crack cocaine is pointedly linked to LBW, preterm delivery, placental displacement and smaller head circumference.


Birth weight Crack cocaine Gestational age Pregnancy Prematurity 


Author contributions

JFS: data collection, project development, manuscript writing and editing, data administration, data interpretation. CMBC: data collection, project development, manuscript writing and editing, data administration, data interpretation. MD: manuscript editing. DLGG: manuscript editing. CQT: manuscript editing. FTB: project development, data administration, data interpretation, data analysis, statistical analysis. AKS: manuscript editing. OWC: project development, scientific knowledge, data collection, project development manuscript writing and editing.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Jucilene Freitas dos Santos
    • 1
  • Cibelle de Melo Bastos Cavalcante
    • 1
  • Fabiano Timbó Barbosa
    • 1
  • Daniel Leite Góes Gitaí
    • 1
  • Marcelo Duzzioni
    • 1
  • Cristiane Queixa Tilelli
    • 2
  • Ashok K. Shetty
    • 3
  • Olagide Wagner de Castro
    • 1
    Email author
  1. 1.Institute of Biological Sciences and HealthFederal University of Alagoas (UFAL)MaceióBrazil
  2. 2.Central-West Campus Dona LinduFederal University of São João del-Rei (UFSJ)DivinópolisBrazil
  3. 3.Department of Molecular and Cellular Medicine, Institute for Regenerative MedicineTexas A&M Health Science Center College of MedicineCollege StationUSA

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