Visual outcome in infants born to drug-misusing mothers prescribed methadone in pregnancy
Visual outcome in infants born to drug-misusing mothers prescribed methadone in pregnancy
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DOI：
10.1136/bjophthalmol-2013-303967
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发表时间：
2014-02-01
影响因子：
4.1
通讯作者：
Mactier, Helen
中科院分区：
文献类型：
--
作者：
McGlone, Laura;Hamilton, Ruth;Mactier, Helen
背景：闪光视觉诱发电位（VEPs）在100例宫内接触美沙酮维持治疗的新生儿中出现异常。这项前瞻性队列研究描述了6个月时的临床视觉和电生理结果。方法视觉评估包括改良的Atkinson测试电池;斜视，眼球震颤，视力下降，延迟视觉成熟或屈光不正（>3屈光度）定义为失败。模式发作的VEP被记录到120 '，60'和15' checks.Results 81药物暴露和26个比较婴儿（79%和52%的原始队列）进行了评估，在中位年龄为27周（范围26-30）。90%的药物暴露婴儿在子宫内额外暴露于非法药物，41%暴露于过量酒精。40%的药物暴露队列未通过临床视觉评估：异常评估的相对风险为5.1（95% CI 1.3 - 20; p=0.02）。眼球震颤特别常见。接触药物的婴儿VEP峰值时间较慢，振幅较小，其中70%有一个或多个异常VEP参数。6个月时的异常视觉结果与额外药物暴露模式或新生儿禁欲史无关。结论滥用药物的母亲所生的婴儿异常视觉电生理持续到6个月大，并与异常的临床视觉评估相关。
Background Flash visual evoked potentials (VEPs) were abnormal in a cohort of 100 neonates exposed to maintenance methadone in utero. This prospective cohort study now describes clinical visual and electrophysiological outcomes at 6 months.Methods Visual assessment included modified Atkinson test battery; strabismus, nystagmus, reduced visual acuity, delayed visual maturation or refractive error (>3 dioptres) defined a fail. Pattern-onset VEPs were recorded to 120', 60' and 15' checks.Results 81 drug-exposed and 26 comparison infants (79% and 52% of the original cohorts) were assessed at a median age of 27 weeks (range 26-30). 90% of drug-exposed infants had been additionally exposed to illicit drugs and 41% to excess alcohol in utero. 40% of the drug-exposed cohort failed clinical visual assessment: the relative risk of abnormal assessment was 5.1 (95% Cl 1.3 to 20; p=0.02). Nystagmus was particularly common. VEP peak times were slower and amplitudes smaller in drug-exposed infants, of whom 70% had one or more abnormal VEP parameter. Abnormal visual outcome at 6 months was not associated with the pattern of additional drug exposure or a history of neonatal abstinence.Conclusions Abnormal visual electrophysiology in infants born to drug-misusing mothers prescribed maintenance methadone persists to 6 months of age, and is associated with abnormal clinical visual assessment.