TOBACCO, CRACK RAISE MISCARRIAGE RISK

BOSTON, Feb. 3 (UPI) - Cigarettes deadlier than crack to unborn babies, but
both substances raise the risk that a woman will suffer a miscarriage, says
a new study.

Roberta B. Ness, who led the research on 970 pregnant women, says those who
smoked had 80 percent more miscarriages. Women who had evidence of cocaine
use, identified through hair analysis, had a 40 percent higher risk of
losing their babies. Ness says her work ``is the first study to show that
cocaine use is linked with subsequent risk of miscarriage.''

There were 400 miscarriages among the women, she says.

She says, ``Tobacco smoking is a bad thing to do at any juncture, but it is
extremely bad during pregnancy.'' This is particularly troubling, she says,
because young women are the fastest growing segment of the population taking
up smoking.

Although researchers don't know why these substances appear to kill fetuses,
Ness speculates they might be restricting the flow of oxygen, essentially
choking the baby in its womb. But other mechanisms may also be at work.

She says, ``We do know that tobacco smoke is comprised of many toxic
substances.''

Marijuana and alcohol did not have a similar effect, says Ness, director of
the Women's Health Program at the University of Pittsburgh Graduate School
of Public Health. She points out, however, that a mother's drinking can harm
babies in other ways.

The study appears in Thursday's issue of the New England Journal of
Medicine. It was funded by the National Institute on Drug Abuse and the
Agency on Health Care Policy Research. Tobacco and cocaine use were measured
by women's own reporting and by urine and hair analysis.

Future research will look at the impact of genetics and domestic violence on
miscarriage, she says.

Ness says national studies show that about 20 percent to 25 percent of women
smoke while pregnant, and in some communities, the rates are higher. In the
low-income group she studied, about one third of the women were smoking
throughout pregnancy.

Cocaine use is harder to pin down, but some scientists estimate that about 5
percent of women of childbearing age have used the drug. In the new study,
about 30 percent of the women had evidence of cocaine use. Ness says the
extremely high rate reflects the study population, which was poor, young,
unmarried women.

Alan I. Leshner, director of the National Institute on Drug Abuse says,
``This research emphasizes that virtually any exposure to illicit drugs is
dangerous for a pregnant woman and her fetus.''

But other scientists are not so sure of the results. In an editorial
accompanying the study, James L. Mills, of the National Institute of Child
Health and Human Development calls the research ``impressive,'' and says
that it ``adds weight to the view that cigarette smoking increases the risk
of spontaneous abortion.''

But he says the findings on cocaine ``do not make an impressive case'' for
the drug's role in fetal death. He says there was no evidence of cocaine in
the urine of women who had miscarriages, only signs of it in hair analysis,
which weakens the conclusion.

Mills says, ``a positive association with both hair and urine tests would
have been more convincing.''