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Look at the maternal risk factors

I asked a neonatologist for this and she said there's no consensus as to which clinical features really tell the difference.
She said in practice our best bet is to look at maternal risk factors. Abruptio, preterm, and polysubstance abuse are more likely to be associated with Cocaine rather than Opioids. In the question they gave two of these risk factors; preterm and multiple substances.
 
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