Neonatal Outcome in Infants With Evidence of Fetal Exposure to Opiates, Cocaine, and Cannabinoids

Nair, Prasanna; Rothblum, Samuel; Hebel, Richard

doi:10.1177/000992289403300505

Cited by 38 publications

(9 citation statements)

References 32 publications

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“…Several studies conducted between 1989 and 1999 that utilized meconium testing and urine sampling were positive for cocaine use among 30% to 45% of births. [17][18][19] However, a large national survey conducted by NIDA in 1995 utilized self-report and found use by only 1.1% of women. 20 Poor birth outcomes resulting from cocaine use during pregnancy include preterm birth, low birth weight, small head circumference, and intrauterine growth restriction.…”

Section: Cocainementioning

confidence: 99%

Overview and Epidemiology of Substance Abuse in Pregnancy

Wendell

2013

Clinical Obstetrics &Amp; Gynecology

116

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The use of licit or illicit substances during pregnancy has the potential to produce adverse health effects for the maternal-fetal dyad. In the United States, it is estimated that >4.4% of pregnant women abuse 1 or more substances during pregnancy. Social and environmental factors contribute significantly to increases in the prevalence and complexity of substance abuse disorders. Fear of reprisal prevents many women from accurately reporting substance use patterns and receiving appropriate medical and psychological care. This chapter details the epidemiology and risk factors associated with substance abuse during pregnancy and subsequent complications for the neonate.

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Section: Cocainementioning

confidence: 99%

Overview and Epidemiology of Substance Abuse in Pregnancy

Wendell

2013

Clinical Obstetrics &Amp; Gynecology

116

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“…The majority of research on substance-exposed infants has been limited to the effects of a single substance, such as cocaine, or opiates, while controlling for the effects of other substances 16 . A small body of research, however, suggests that infants with cocaine and opiate exposure may be at greater risk for poor developmental outcomes 8,17 . Infants with prenatal cocaine 1,8 and opiate 18 exposure are at risk for difficulties with modulating arousal and attention, and subsequent problems with emotion regulation 1,19 and learning 20 by middle childhood.…”

Section: Discussionmentioning

confidence: 99%

Prenatal Substance Exposure: Neurobiologic Organization at 1 Month

Conradt

Sheinkopf

Lester

et al. 2013

The Journal of Pediatrics

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Objective To examine the autonomic nervous system and neurobehavioral response to a sustained visual attention challenge among 1-month old infants with prenatal substance exposure. Study design We measured heart rate (HR), respiratory sinus arrhythmia (RSA), and neurobehavior during sustained visual orientation tasks included in the NICU Network Neurobehavioral Scale (NNNS) in 1,129, 1-month infants with prenatal substance exposure. Four groups were compared: infants with prenatal cocaine and opiate exposure, infants with cocaine exposure, infants with opiate exposure, and infants with exposure to other substances (i.e. alcohol, marijuana, and tobacco). Results Infants with prenatal cocaine and opiate exposure had the highest HRs and lowest levels of RSA during a sustained visual attention procedure compared with the other three groups. Infants with prenatal cocaine and opiate exposure had poorer quality of movement and more hypertonicity during the NNNS exam compared with the other three exposure groups. Infants with prenatal cocaine and opiate exposure had more nonoptimal reflexes and stress/abstinence signs compared with infants with prenatal cocaine exposure only and infants with prenatal exposure to alcohol, tobacco, and marijuana. Conclusions Problems with arousal regulation were identified among infants with prenatal substance exposure. Autonomic dysregulation has been implicated as a mechanism by which these difficulties occur. Our results suggest that infants with both prenatal cocaine and opiate exposure have the greatest autonomic response to the challenge of a sustained visual attention task, which may place these infants at risk for developing problems associated with physiological and behavioral regulation, a necessary prerequisite for early learning.

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“…A explicação para esse fato pode estar relacionada à entrevista estruturada, que não teve caráter punitivo e foi realizada por um profissional habilitado da área da saúde mental. Por outro lado, em contraste com as taxas relativamente altas da entrevista, a análise do mecô-nio mostrou taxas menores de exposição pré-natal à cocaína que as usualmente descritas em outros estudos locais, que também utilizaram o mecônio para a testagem, provavelmente relacionadas ao tipo de população estudada [33][34][35] .…”

Section: Discussionunclassified

Prevalence of prenatal exposure to cocaine in a sample of newborns from a university teaching hospital

et al. 2001

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Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém-nascidos utilizando dois méto-dos: a fluorescência polarizada por imunoensaio no mecônio e a entrevista materna.Método: estudo transversal realizado num hospital geral universitário, abrangendo todos os recém-nascidos nascidos vivos no centro obstétrico do hospital durante o período de 23 de março de 1999 a 1 de junho de 1999 (847 recém-nascidos). A presença de exposição pré-natal à cocaína foi definida por um teste de fluorescência polarizada por imunoensaio positivo para benzoilecgonina no mecônio do recém-nascido e/ou por uma entrevista materna positiva.Resultados: a taxa da exposição pré-natal à cocaína foi de 16 casos (2,4%), através da entrevista, e de 25 casos (3,4%) através da testagem do mecônio. Foram encontrados 34 casos, com uma prevalência de 4,6%, quando os métodos para a detecção foram considerados de forma complementar.Conclusões: através deste estudo, foi observado que a testagem meconial é mais eficaz que a entrevista materna no diagnóstico da exposição pré-natal à cocaína. A entrevista aumentou, em relação à testagem do mecônio, em 26% a possibilidade do diagnóstico da exposição; e a testagem do mecônio, em relação à entrevista, aumentou em 53,4% o diagnóstico da exposição. AbstractObjective: to assess the prevalence of prenatal exposure to cocaine in a sample of newborns using two methods: fluorescence polarization immunoassay and interview with the mother.Methods: this cross-sectional study was carried out in a university teaching hospital. The population included all live births between March 23, 1999 and June 01, 1999 (n=847). Exposure was determined by a benzoylecgonine-positive meconium specimen and/ or by a positive interview with the mother.Results: the prevalence of prenatal exposure to cocaine in this sample was 2.4% (16 cases) according to the interviews, and 3.4% (25 cases) according to the meconium analysis. A rate of 4.6% (34 cases) was found when both methods were associated.Conclusions: we observed that the meconium test was more effective than the maternal interview for the diagnosis of prenatal exposure to cocaine. The meconium analysis enhanced diagnostic chances by 53.4%, compared to 26% in the case of maternal interview. J Pediatr (Rio IntroduçãoNos Estados Unidos (EUA), no final da década de 70, o uso de cocaína começou a tornar-se visível tanto no meio urbano quanto no meio rural. Na década de 80, surgiu a epidemia do crack, iniciaram os relatos de abuso infantil, negligência e abandono sofridos por filhos de pais usuários e do uso de cocaína e outras drogas durante a gestação 1 .O desenvolvimento do sistema nervoso central inicia no 28 o dia após a concepção e continua durante a gestação e toda a infância, conferindo-lhe uma vulnerabilidade bioló-gica continuada a insultos tóxicos. A cocaína pode afetar a formação e o remodelamento do cérebro através do efeito nos neurotransmissores. A cocaína, simulando a ação de neurotransmissores ou modificando a atividade dos seus

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Neonatal Outcome in Infants With Evidence of Fetal Exposure to Opiates, Cocaine, and Cannabinoids

Cited by 38 publications

References 32 publications

Overview and Epidemiology of Substance Abuse in Pregnancy

Overview and Epidemiology of Substance Abuse in Pregnancy

Prenatal Substance Exposure: Neurobiologic Organization at 1 Month

Prevalence of prenatal exposure to cocaine in a sample of newborns from a university teaching hospital

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