 |
|
Acute Neonatal Effects of Cocaine Exposure During Pregnancy
Charles R. Bauer, MD;
John C. Langer, MSc;
Seetha Shankaran, MD;
Henrietta S. Bada, MD;
Barry Lester, PhD;
Linda L. Wright, MD;
Heidi Krause-Steinrauf, MS;
Vincent L. Smeriglio, PhD;
Loretta P. Finnegan, MD;
Penelope L. Maza, PhD;
Joel Verter, PhD
Arch Pediatr Adolesc Med. 2005;159:824-834.
Objective To identify associations between cocaine exposure during pregnancy and medical conditions in newborn infants from birth through hospital discharge.
Design Multisite, prospective, randomized study.
Setting Brown University, University of Miami, University of Tennessee (Memphis), and Wayne State University.
Subjects A total of 717 cocaine-exposed infants and 7442 nonexposed infants.
Main Outcome Measures Results of physical examination and conditions observed during hospitalization.
Results Cocaine-exposed infants were about 1.2 weeks younger, weighed 536 g less, measured 2.6 cm shorter, and had head circumference 1.5 cm smaller than nonexposed infants (all P<.001). Results did not confirm previously reported abnormalities. Central and autonomic nervous system symptoms were more frequent in the exposed group: jittery/tremors (adjusted odds ratio, 2.17; 99% confidence interval, 1.44-3.29), high-pitched cry (2.44; 1.06-5.66), irritability (1.81; 1.18-2.80), excessive suck (3.58; 1.63-7.88), hyperalertness (7.78; 1.72-35.06), and autonomic instability (2.64; 1.17-5.95). No differences were detected in organ systems by ultrasound examination. Exposed infants had more infections (3.09; 1.76-5.45), including hepatitis (13.46; 7.46-24.29), syphilis (8.84; 3.74-20.88), and human immunodeficiency virus exposure (12.37; 2.20-69.51); were less often breastfed (0.26; 0.15-0.44); had more child protective services referrals (48.92; 28.77-83.20); and were more often not living with their biological mother (18.70; 10.53-33.20).
Conclusions Central and autonomic nervous system symptoms were more frequent in the exposed cohort and persisted in an adjusted analysis. They were usually transient and may be a true cocaine effect. Abnormal anatomic outcomes previously reported were not confirmed. Increased infections, particularly sexually transmitted diseases, pose a serious public health challenge. Exposure increased involvement of child protective services and out-of-home placement.
Author Affiliations: Department of Pediatrics, University of Miami School of Medicine, Miami, Fla (Dr Bauer); Research Triangle Institute, Research Triangle Park, NC (Mr Langer); Department of Pediatrics, Wayne State University School of Medicine, Detroit, Mich (Dr Shankaran); Department of Pediatrics, University of Tennessee, Memphis, College of Medicine (Dr Bada); Department of Pediatrics, Brown Medical School, Women’s and Infants’ Hospital, Providence, RI (Dr Lester); National Institute of Child Health and Human Development, Bethesda, Md (Dr Wright); The George Washington University Biostatistics Center, Washington, DC (Ms Krause-Steinrauf and Dr Verter); National Institute on Drug Abuse, Bethesda (Dr Smeriglio); Center for Substance Abuse Treatment, Washington (Dr Finnegan); and Administration on Children, Youth, and Families, Washington (Dr Maza). Dr Bada is now at the University of Kentucky, Lexington. Dr Finnegan is now at the Office of Research on Women’s Health, National Institutes of Health, Bethesda.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Effects of Prenatal Cocaine Exposure on Special Education in School-Aged Children
Levine et al.
Pediatrics 2008;122:e83-e91.
ABSTRACT
| FULL TEXT
The Thrill Can Kill: Murder by Methylation
Barik
Mol. Pharmacol. 2007;71:1203-1205.
ABSTRACT
| FULL TEXT
Impact of Prenatal Cocaine Exposure on Child Behavior Problems Through School Age
Bada et al.
Pediatrics 2007;119:e348-e359.
ABSTRACT
| FULL TEXT
Prenatal cocaine exposure and child welfare outcomes.
Doris et al.
Child Maltreat 2006;11:326-337.
ABSTRACT
Fetal origin of childhood disease: intrauterine growth restriction in term infants and risk for hypertension at 6 years of age.
Shankaran et al.
Arch Pediatr Adolesc Med 2006;160:977-981.
ABSTRACT
| FULL TEXT
|
