Association between patterns of maternal substance use and infant birth weight, length, and head circumference
Association between patterns of maternal substance use and infant birth weight, length, and head circumference
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DOI：
10.1542/peds.114.2.e226
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发表时间：
2004-08-01
期刊：
影响因子：
8
通讯作者：
Smeriglio, V
中科院分区：
文献类型：
--
作者：
Shankaran, S;Das, A;Smeriglio, V
Objective.确定足月妊娠期间药物使用模式对婴儿出生时生长参数的影响。在婴儿1个月的随访中，记录了怀孕前3个月和怀孕3个月期间可卡因、阿片类药物、酒精、烟草和大麻的使用史。使用模式被分类为持续高，中度，或低/无或增加/减少，并在多变量线性回归分析中分析对生长参数的影响，并对临床部位，母亲年龄，孕前体重，多种药物使用和社会经济状况进行调整。共有241名可卡因暴露妇女和410名非可卡因暴露妇女参加了这项研究。在可卡因暴露组中，75%使用酒精，90%使用烟草，53%使用大麻;在非可卡因暴露组中，57%使用酒精，34%使用烟草，19%使用大麻。出生体重，出生身长，头围出生的妇女谁没有使用毒品，与任何可卡因，鸦片，酒精，烟草，或大麻使用的妇女相比，显着更大的婴儿中出生的婴儿可卡因非用户，与可卡因用户相比。调整混杂因素后，可卡因（持续低模式的250 g缺陷）和烟草（持续高模式的232 g缺陷，持续中等模式的173 g缺陷，持续降低模式的153 g缺陷和持续低模式的103 g缺陷）显著影响出生体重。头部大小受到可卡因（0.98厘米的赤字与一贯的中度模式）和烟草（赤字0.72厘米与一贯的高模式和0.89厘米与一贯的中度模式）。出生身长仅受烟草使用的影响（持续高模式的缺陷为0.82 cm，减少使用的缺陷为0.98 cm）。怀孕期间的烟草使用模式影响出生体重，长度和头围，而可卡因影响出生体重和头围，当调整混杂因素时，包括多药使用。
Objective. To determine the effects of patterns of drug use during term pregnancy on infant growth parameters at birth.Methods. Histories of cocaine, opiate, alcohol, tobacco, and marijuana use during the 3-month period before pregnancy and the 3 trimesters of pregnancy were recorded at the infants' 1-month visit. Patterns of use were categorized as consistently high, moderate, or low/none or increasing/decreasing, and effects on growth parameters were analyzed in multivariate linear regression analyses, with adjustment for clinical site, maternal age, prepregnancy weight, multidrug use, and socioeconomic status.Results. A total of 241 cocaine-exposed women and 410 non-cocaine-exposed women participated in the study. In the cocaine-exposed group, 75% used alcohol, 90% used tobacco, and 53% used marijuana; in the non cocaine-exposed group, 57% used alcohol, 34% used tobacco, and 19% used marijuana. Birth weight, birth length, and head circumference were significantly greater among infants born to women who used no drugs, compared with women with any cocaine, opiate, alcohol, tobacco, or marijuana use, and were greater among infants born to cocaine nonusers, compared with cocaine users. With adjustment for confounders, birth weight was significantly affected by cocaine ( deficit of 250 g with consistently low pattern) and tobacco ( deficits of 232 g with consistently high pattern, 173 g with consistently moderate pattern, 153 g with decreasing pattern, and 103 g with consistently low pattern). Head size was affected by cocaine (deficit of 0.98 cm with consistently moderate pattern) and tobacco (deficits of 0.72 cm with consistently high pattern and 0.89 cm with consistently moderate pattern). Birth length was affected by tobacco use only (deficits of 0.82 cm with consistently high pattern and 0.98 cm with decreasing use).Conclusion. Patterns of tobacco use during pregnancy affect birth weight, length, and head circumference, whereas cocaine affects birth weight and head size, when adjustments are made for confounders, including multidrug use.