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April 20, 1994

Association Between Newborn Birth Weight and Prenatal Care for Cocaine Users

Author Affiliations

Harlan, Ky

JAMA. 1994;271(15):1161. doi:10.1001/jama.1994.03510390031023

To the Editor.  —I must compliment Dr Racine and colleagues1 on their statistical tour de force. I also compliment them on their honesty, particularly the fourth from last paragraph in the Comment section, which puts into doubt any conclusion from their data.In comparing groups of women who voluntarily do or do not pursue prenatal care, it seems a redundant conclusion that women who seek prenatal care are going to be more concerned about their health and are going to be more judicious in those areas of behavior that may affect the birth weight of their infant, even if they do use cocaine, than those who do not seek prenatal care.It seems more likely that the authors have really identified two different social strata of cocaine users, one more socially adapted than the other. Therefore, the conclusion that compelling women who are using cocaine to complete four prenatal

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