No abstract

An analysis of birthweights of 337 neonates in relation to history of maternal narcotic usage was undertaken Mean birthweight of infants born to mothers abusing heroin during the pregnancy was 2,490 gm, an effect primarily of intrauterine growth retardation. Low mean birthweight (2,615 gm) was also seen in infants born to mothers who had abused heroin only prior to this pregnancy, and mothers who had used both heroin and methadone during the pregnancy (2,535 gm). Infants born to mothers on methadone maintenance during the pregnancy had significantly higher mean birthweights (2,961 gm), but lower than the control group (3,176 gm). A highly significant relationship was observed between maternal methadone dosage in the first trimester and birthweight, i.e., the higher the dosage, the larger the infant. Heroin causes fetal growth retardation, an effect which may persist beyond the period of addiction. Methadone may promote fetal growth in a dose-related fashion after maternal use of heroin.

, content and e v a l u a t i o n method were made known p r i o r t o t h e experience. Evaluation was done i n the above emphasis areas. Student a t t i t u d e s were q u a n t i f i e d using pre-established c r i t e r i a .Students, upon completion of t h e c l e r ks h i p and l a t e r a s housestaff, were asked t o permit 2 supervisors t o evaluate t h e i r performance a s housestaff. One hundred f i f t e e n s t u d e n t s responded and 153 e v a l u a t i o n s were made by housestaff supervisors. Performance was analyzed and comparisons made of emphasis a r e a s an w e l l a s between c l e r k s h i p , housestaff, and Nat i o n a l Board performances. Performance was compared t o s p e c i a l t y choice and graduates indicated the degree of c l e r k s h i p influence, i f any, on t h e i r choice.Achievement wan documented by: National Boards (NB) (Pass: Clerkship-99%/~S-97%); e v a l u a t i o n of housestaff (HS)(96% no d e f ic i t i n ped. knowledge, average o r above performance: c l e r k s h i p -79%/NB-99%); and r e t r o s p e c t i v e assessment by HS (objectives highl y appropriate-47% and preparation e x p e c i a l l y strong-612). There were n o t a b l e d i f f e r e n c e s i n performances f o r various o b j e c t i v e s and a l l exce a t t i t u d e c o r e l a e w t h a p e c i a l t cho ce (ped. HS significan!fy higher than 5 an3 o i s i x s p e c i a l t y c i o i c e s ) . GESTATIONAL AGE ESTIMATION IN SICK NEWBOWSCecelia Daum. Diane Kurtzberg. Bruce Grellong, Susan Albin and Herbert Vaughan (Spon. by Lawrence Gartner),Departmenta of P e d i a t r i c s , Neuroscience and Psychiatry. Albert E i n s t e i n College of Medicine, Bronx, New YorkThe Dubowitz examination f o r e s t i m a t i o n of g e s t a t i o n a l age is o f t e n d i f f i c u l t o r impossible t o administer i n i t s e n t i r e t y i n s i c k i n f a n t s , e s p e c i a l l y those receiving v e n t i l a t o r y support. A shortened v e r s i o n of t h e examination has been devised which permits assessment of g e s t a t i o n a l age with minimal l o s s of p r e d i c t i v e accuracy. The complete Dubowitz examination was adminiatered t o 112 i n f a n t s from 29 t o 42 weeks g e s t a t i o n a l age. Factor a n a l y s i s and atepwise r e g r e s s i o n were performed t o i d e n t i f y t h e items t h a t contributed preponderantly t o t h e t o t a l variance. Three non-discriminating items (edema, s k i n c o l o r , posture) were eliminated on t h e b a s i s of t h e s e analyses, a s well a s t h r e e a d d i t i o n a l items (lanugo, head l a g , v e n t r a l suspension) which cannot be assessed i n i n f a n t s on r e s p i r a t o r s . The shortened s c a l e c o r r e l a t e d highly with t h e t o t a l Dubowitz score ( r -.985), providing a n instrument which can be admini s t e r e d t o s e r i o u s l y ill i n f a n t s with l i t t l e l o s s of pred i c t i v e accuracy (95% confidence l i m i t * 1 week). NEUROBEHAVIORAL ASSESSMENT OF HIGH-RISK NEONATE...