The relationship between illicit drug use and pregnancy outcome is controversial. Self-reported drug use is notoriously inaccurate, and selective screening for drug use often results in biased ascertainment. IN this project, serum obtained from approximately 7,500 women on entry to the Vaginal Infections and Prematurity Study (23-26 weeks) was screened for marijuana and cocaine metabolites. In addition, serum obtained at delivery of preterm and a random sample of term infants was screened. This will help elucidate in an unbiased manner the association between use of these substances and adverse pregnancy outcome.