Dose-response effect of cocaine on newborn head circumference
Dose-response effect of cocaine on newborn head circumference
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DOI：
10.1542/peds.106.3.e33
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发表时间：
2000-09-01
期刊：
影响因子：
8
通讯作者：
Chiriboga, CA
中科院分区：
文献类型：
--
作者：
Bateman, DA;Chiriboga, CA
客观的。评估子宫内接触可卡因的健康足月和近足月新生儿的头围、出生体重和可卡因剂量之间的关系。方法。我们使用母亲头发中可卡因代谢物的放射免疫测定 (RIAH) 来量化 240 名健康新生儿（胎龄：> 36 周）在妊娠晚期的可卡因暴露量。可卡因暴露分为 3 个级别：无暴露（n = 136）、低可卡因暴露（n = 52；RIAH：2-66 ng/10 mg 头发）和高可卡因暴露（n = 52；RIAH：81-4457 ng/10 mg 头发）。我们通过结构化访谈和医疗记录收集了有关孕产妇人口统计特征、怀孕和药物使用的信息。结果。可卡因接触量高的婴儿的出生体重、身长和头围平均值与接触量低和未接触的婴儿显着不同，但接触量低和未接触的婴儿的出生体重、身长和头围的平均值相似。我们使用多元线性回归模型来评估新生儿头围和可卡因水平之间的关联，并调整出生体重的影响；胎龄；婴儿性行为；以及一些母体因素，包括身高、怀孕期间体重增加、怀孕期间梅毒以及怀孕期间使用酒精、香烟、大麻和阿片类药物。只有出生体重、性别和高可卡因暴露与新生儿头围显着相关。与高可卡因暴露相关的预测头围缺陷 (0.44 cm) 代表高可卡因暴露组和无暴露组婴儿平均头围之间未经调整的差异 (1.28 cm) 的 34%。结论。在子宫内接触高浓度可卡因（RIAH：>81 ng/10 mg 头发）的新生儿会表现出不对称的宫内生长迟缓，其中头围不成比例地小于根据出生体重预测的值（头部消瘦）。与可卡因接触相关的头部尺寸缺陷可能反映了干扰产前大脑生长的特定中枢神经系统损伤的影响。
Objective. To evaluate the relationship between head circumference, birth weight, and cocaine dose in healthy term and near-term newborns exposed to cocaine in utero.Methods. We used radioimmune assay (RIAH) of cocaine metabolite in maternal hair to quantify third trimester cocaine exposure in 240 healthy newborn infants (gestational age: >36 weeks). Cocaine exposure was categorized into 3 levels: no exposure (n = 136), low cocaine exposure (n = 52; RIAH: 2-66 ng/10 mg hair), and high cocaine exposure (n = 52; RIAH: 81-4457 ng/10 mg hair). We collected information on maternal demographic characteristics, the pregnancy, and the use of substances through a structured interview and from the medical record.Results. Means of birth weight, length, and head circumference of infants with high cocaine exposure differed significantly from those with low exposure and no exposure, but were similar between low exposure and no exposure. We used a multiple linear regression model to assess the association between newborn head circumference and cocaine level, adjusting for the effects of birth weight; gestational age; infant sex; and several maternal factors, including height, weight gain during pregnancy, syphilis during pregnancy, and the use of alcohol, cigarettes, marijuana, and opiates during pregnancy. Only birth weight, sex, and high cocaine exposure were significantly associated with newborn head circumference. The predicted head circumference deficit associated with high cocaine exposure (.44 cm) represents 34% of the unadjusted difference (1.28 cm) between mean head circumferences of infants in the high cocaine exposure and no exposure groups.Conclusion. Newborns exposed to a high level of cocaine in utero (RIAH: >81 ng/10 mg hair) exhibit asymmetric intrauterine growth retardation in which the head circumference is disproportionately smaller than would be predicted from the birth weight (head wasting). The deficit in head size associated with cocaine exposure may reflect the effects of a specific central nervous system insult that interferes with prenatal brain growth.