Electroencephalographic and behavioral-state studies in infants of cocaine-addicted mothers
A. Legido, R. R. Clancy, A. R. Spitzer and L. P. Finnegan
Division of Neurology, Children's Hospital of Philadelphia, Pa.
OBJECTIVE--To evaluate cerebral cortical function with
electroencephalography in infants of cocaine-addicted mothers.
DESIGN--Patient series. SETTING--The Children's Hospital of Philadelphia
(Pa). PARTICIPANTS--Thirty-five consecutive infants of cocaine-addicted
mothers hospitalized for a comprehensive health assessment and 51 healthy,
age-matched infants studied with electroencephalography and respiratory
thermistor because they were siblings of sudden infant death victims
(comparison group). INTERVENTIONS--None. MEASUREMENTS/MAIN
RESULTS--Behavioral states during spontaneous daytime sleep were classified
as active sleep or quiet sleep; quiet sleep was further characterized as
immature, trace alternant sleep or mature, continuous, slow wave sleep. No
episodes of ictal apnea or nonictal apnea were recorded in infants of
cocaine-addicted mothers; nonictal apnea was observed in one control
patient. No electrographic seizures were recorded. There were no
significant differences between the proportions of infants exposed to
cocaine in utero and that of controls who displayed excessive sharp
electroencephalographic transients, background abnormalities, immaturity,
and hypermaturity. Electroclinical sleep discordance was present in 5.7% of
infants of cocaine-addicted mothers vs 0% of controls. Cocaine-exposed
infants displayed mature, continuous, slow wave sleep below 45 weeks of
conceptional age in a significantly higher percentage than those in the
comparison group. CONCLUSIONS--Although frank electroencephalographic
abnormalities were infrequent in infants whose mothers were addicted to
cocaine, they differed significantly in their younger age of onset of
continuous, slow wave sleep. Our findings provide continued reason for
concern that infants of cocaine-addicted mothers may suffer subtle adverse
neurologic, cognitive, or behavioral effects later in life. The
longitudinal assessment of sleep disturbance and its relation to later
development might permit tracking of the long-term effects of prenatal
exposure to cocaine.
