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Elevated Plasma Norepinephrine Levels in Infants of Substance-Abusing Mothers
Sally L. Davidson Ward, MD;
Sally Schuetz, RN, CPNP;
Laura Wachsman, MD;
Xylena D. Bean, MD;
Daisy Bautista;
Sue Buckley;
Sabitha Sehgal, MD;
David Warburton, MB, MRCP
Am J Dis Child. 1991;145(1):44-48.
Abstract
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•Infants of substance-abusing mothers (ISAM) have significant growth and neurodevelopmental abnormalities. The origin of these abnormalities is unknown. We postulated that ISAM have increased sympathetic nervous system tone and altered catecholamine levels. Therefore, we measured plasma norepinephrine, epinephrine, and dopamine levels and the number and receptor affinity of β-adrenoreceptor binding sites on lymphocytes and  -adrenoreceptor binding sites on thrombocytes in 22 otherwise healthy ISAM (age, 2.1 ±0.5 months; mean±SD) and 15 healthy controls (age, 2.5 ±0.8 months). Norepinephrine levels in venous blood were 1.8-fold higher in ISAM than in control infants (6.30 ±3.85 nmol/L vs 3.55 ±2.45 nmol/L). There were no differences in plasma epinephrine or dopamine levels. There were no differences in the number of binding sites or receptor affinity for β- and -adrenoreceptors. We conclude that ISAM have elevated circulating norepinephrine levels compared with controls. We speculate that this is associated with increased sympathetic nervous system tone in ISAM and that the absence of adrenoreceptor down-regulation may create catecholamine suprasensitivity.
(AJDC. 1991;145:44-48)
Author Affiliations
From the Division of Neonatology and Pediatric Pulmonology, Childrens Hospital of Los Angeles (Drs Ward and Warburton and Mss Bautista and Buckley); Los Angeles County—University of Southern California Medical Center (Drs Ward, Wachsman, and Warburton, and Ms Schuetz), Department of Pediatrics, University of Southern California School of Medicine (Mss Bautista and Buckley); and Martin Luther King, Jr, General Hospital, Charles R. Drew Postgraduate Medical School (Drs Bean and Sehgal), Los Angeles, Calif.
Footnotes
Accepted for publication April 9,1990.
Read before the New York Academy of Sciences Conference on Prenatal Abuse of Licit and Illicit Drugs, Bethesda, Md, September 9,1988.
Reprint requests to Division of Neonatology and Pediatric Pulmonology, Childrens Hospital of Los Angeles, 4650 Sunset Blvd, Bin 83, Los Angeles, CA 90027 (Dr Ward).
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