Prenatal cocaine exposure is associated with respiratory pattern abnormalities
I. J. Chasnoff, C. E. Hunt, R. Kletter and D. Kaplan
Department of Pediatrics, Northwestern University Medical School, Chicago, Ill.
As retrospectively determined, the rate of sudden infant death syndrome in
66 infants prenatally exposed to cocaine was 15%, compared with only 4%
among infants exposed to opiates. This prospective evaluation of
cardiorespiratory pattern in 32 cocaine-exposed and 18 methadone-exposed
infants was therefore performed to further evaluate the effects of
intrauterine exposure. The two groups were similar in maternal age, race,
and cigarette, alcohol, and marijuana use and in gestational age, sex, and
birth weight. Apnea density and episodes of periodic breathing exceeded the
95th percentile for normal infants in 12 (38%) of 32 of cocaine-exposed
infants vs only 1 (6%) of 18 opiate-exposed infants. Five cocaine-exposed
but no opiate-exposed infants had apnea of infancy, and all 5 of these
infants had an abnormal cardiorespiratory pattern. In all 13 infants with
an abnormal cardiorespiratory pattern, theophylline treatment resulted in
normalization of the respiratory pattern and was associated with absence of
any (further) clinical events. In summary, infants prenatally exposed to
cocaine have a higher incidence of cardiorespiratory pattern abnormalities
than do infants with methadone or no prenatal drug exposure.
