Study Links Miscarriage to Use of Tobacco and Possibly Crack Cocaine

Smoking tobacco and crack cocaine may account for one-quarter of spontaneous abortions experienced by poor women, researchers report in today’s New England Journal of Medicine. The link between tobacco and miscarriage has been known for years and the new study confirms it, showing 80% more spontaneous abortions among women whose urine had evidence of cigarette use.

The connection between cocaine use and miscarriage has been more controversial and is likely to remain so, even though the new study, led by Dr. Roberta B. Ness of the University of Pittsburgh, showed a 40% increase in miscarriage risk when cocaine was used during pregnancy. Ness and her colleagues used hair analysis and urine tests to compare the drug use of 400 women who had had a miscarriage to the drug use of 570 who had not.

An accompanying editorial by Dr. James L. Mills of the National Institute of Child Health and Human Development, however, noted that technical questions about the Ness study remain, and therefore the results “do not make an impressive case for cocaine as a cause of spontaneous abortion.”

Compiled by Times medical writer Thomas H. Maugh II