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Agustín Legido, MD; Robert R. Clancy, MD; Alan R. Spitzer, MD; Loretta P. Finnegan, MD

Am J Dis Child. 1992;146(6):748-752.

Abstract
• 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, tracé 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.

(AJDC. 1992;146:748-752)

Author Affiliations
From the Divisions of Neurology (Drs Legido and Clancy) and Neonatology (Dr Spitzer), The Children's Hospital of Philadelphia; the Departments of Pediatrics (Dr Spitzer) and Neurology (Drs Legido and Clancy), University of Pennsylvania School of Medicine; and the Departments of Pediatrics and Psychiatry (Dr Finnegan), Thomas Jefferson University Hospital, Philadelphia, Pa.

Footnotes
Accepted for publication January 17, 1992.

Presented in part at the Child Neurology Society Meeting, Halifax, Nova Scotia, September 16, 1988, and abstracted in Annals of Neurology (1988;24:328).

Reprint requests to St. Christopher's Hospital for Children, Section of Neurology, Erie Avenue at Front Street, Philadelphia, PA 19134-1095 (Dr Legido).

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