Elevated plasma norepinephrine after in utero exposure to cocaine and marijuana.
Elevated plasma norepinephrine after in utero exposure to cocaine and marijuana.
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DOI：
10.1542/peds.99.4.555
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发表时间：
1997-04
期刊：
影响因子：
8
通讯作者：
M. Mirochnick;J. Meyer;D. Frank;H. Cabral;E. Tronick;B. Zuckerman
中科院分区：
文献类型：
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作者：
M. Mirochnick;J. Meyer;D. Frank;H. Cabral;E. Tronick;B. Zuckerman
目的 比较接触可卡因和未接触可卡因的足月新生儿血浆儿茶酚胺浓度，并确定血浆儿茶酚胺与新生儿行为之间的关系。方法 对参与一项关于产前可卡因暴露对新生儿和长期影响的前瞻性研究的 46 名新生儿进行了研究。根据产妇自我报告、产妇尿液筛查和婴儿胎便分析，24 名婴儿被归类为可卡因暴露者，22 名婴儿被归类为未暴露者。产后 24 至 72 小时之间，获取血浆样本用于去甲肾上腺素 (NE)、肾上腺素、多巴胺和二羟基苯丙氨酸分析。新生儿行为评估量表在新生儿 1 至 3 天和 2 周龄时由不了解新生儿药物暴露状况的检查员进行。结果 与未接触可卡因的婴儿相比，接触可卡因的新生儿血浆 NE 浓度升高（几何平均值为 923 pg/mL vs 667 pg/mL）。血浆肾上腺素、多巴胺或二羟基苯丙氨酸浓度没有显着差异。对潜在混杂变量影响的分析显示，母亲吸食大麻也与血浆 NE 增加相关，尽管出生体重、性别以及母亲饮酒或吸烟则不然。在子宫内同时接触可卡因和大麻的婴儿中，几何平均血浆 NE 为 1164 pg/mL，而仅接触可卡因的婴儿的几何平均血浆 NE 为 812 pg/mL，而未接触可卡因的婴儿的几何平均血浆 NE 为 667 pg/mL。在接触可卡因的婴儿中，血浆 NE 浓度与 1 至 3 天龄时进行的新生儿行为评估量表的抑郁簇评分增加 (r = .53) 和定向簇评分降低 (r = -.43) 相关。调整大麻暴露对血浆 NE 与抑郁和定向簇之间的关系没有影响。结论 接触可卡因和大麻的新生儿血浆 NE 增加。血浆 NE 增加与可卡因暴露婴儿在出生后 1 至 3 天（但在 2 周时）的特定神经行为紊乱有关。
OBJECTIVE To compare plasma catecholamine concentrations between cocaine-exposed and unexposed term newborns and to determine the relationship between plasma catecholamines and newborn behavior. METHODS Forty-six newborn infants participating in a prospective study of the neonatal and long-term effects of prenatal cocaine exposure were studied. Based on maternal self-report, maternal urine screening, and infant meconium analysis, 24 infants were classified as cocaine-exposed and 22 as unexposed. Between 24 and 72 hours postpartum, plasma samples for norepinephrine (NE), epinephrine, dopamine, and dihydroxyphenylalanine analysis were obtained. The Neonatal Behavioral Assessment Scale was administered at 1 to 3 days of age and at 2 weeks of age by examiners masked to the drug exposure status of the newborns. RESULTS The cocaine-exposed newborns had increased plasma NE concentrations when compared to the unexposed infants (geometric mean, 923 pg/mL vs 667 pg/mL). There were no significant differences in plasma epinephrine, dopamine, or dihydroxyphenylalanine concentrations. Analysis for the effect of potential confounding variables revealed that maternal marijuana use was also associated with increased plasma NE, although birth weight, gender, and maternal use of alcohol or cigarettes were not. Geometric mean plasma NE was 1164 pg/mL in those infants with in utero exposure to both cocaine and marijuana compared to 812 pg/mL in those exposed to only cocaine and 667 pg/mL in those exposed to neither. Among the cocaine-exposed infants, plasma NE concentration correlated with an increased score for the depressed cluster (r = .53) and a decreased score for the orientation cluster (r = -.43) of the Neonatal Behavioral Assessment Scale administered at 1 to 3 days of age. Adjusting for marijuana exposure had no effect on these relationships between plasma NE and the depressed and orientation clusters. CONCLUSION Plasma NE is increased in newborns exposed to cocaine and marijuana. Increased plasma NE is associated with selected neurobehavioral disturbances among cocaine exposed infants at 1 to 3 days of life but not at 2 weeks.