Prenatal cocaine exposures and dose-related cocaine effects on infant tone and behavior

Prenatal cocaine exposures and dose-related cocaine effects on infant tone and behavior
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DOI:
10.1016/j.ntt.2006.12.002
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发表时间:
2007-05-01
影响因子:
2.9
通讯作者:
Wasserman, Gail A.
Wasserman, Gail A.
中科院分区:
医学3区
文献类型:
--
作者:
Chiriboga, Claudia A.;Kuhn, Louise;Wasserman, Gail A.

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背景:在实验模型中,已发现产前可卡因暴露干扰单胺能发育。在人类中,许多研究都寻求临床相关性,但很少有集中在剂量相关的影响,特别是关于神经功能超出新生儿period.Objective:为了评估是否产前可卡因暴露对婴儿神经,发育和行为的结果有不良影响,是否有任何影响是剂量依赖性的。设计/方法:婴儿(398)在出生时从城市医院。通过毛发(n=395)、尿液(n = 170)和胎粪(n = 109)中的生物标志物确定药物暴露。对286名儿童(72%)进行前瞻性随访,在6个月大时使用Bayley量表、Fagan婴儿智力量表和标准化神经系统检查对药物暴露进行盲法评估。在母体头发中检测到的可卡因量显著增加了某些神经学发现,例如音调异常,如伸肌姿势所示,在未接触可卡因的婴儿中检测到28%,在接触较低和较高可卡因水平的婴儿中分别检测到43%和48%(P
Background: In experimental models, prenatal cocaine exposure has been found to perturb monoaminergic development. In humans, numerous studies have sought clinical correlates, but few have focused on dose-related effects, especially as regards neurologic function beyond the neonatal period.Objective: To assess whether prenatal cocaine exposure has adverse effects on infant neurologic, developmental and behavioral outcomes and whether any effects are dose-dependent.Design/Methods: Infants (398) were enrolled at birth from an urban hospital. Drug exposure was ascertained with biomarkers in hair (n=395), urine (n = 170) and meconium (n = 109). Children were followed prospectively and 286 (72%) were evaluated blind to drug exposure at 6 months of age with the Bayley scales, Fagan Scale of Infant Intelligence and a standardized neurological examination.Results: Certain neurological findings increased significantly by the amount of cocaine detected in maternal hair, e.g. abnormality of tone, as indicated by extensor posture was detected among 28% of cocaine-unexposed infants, 43% of infants exposed to lower and 48% exposed to higher cocaine levels in maternal hair (p