The infant development, environment, and lifestyle study: Effects of prenatal methamphetamine exposure, polydrug exposure, and poverty on intrauterine growth
The infant development, environment, and lifestyle study: Effects of prenatal methamphetamine exposure, polydrug exposure, and poverty on intrauterine growth
复制标题
DOI：
10.1542/peds.2005-2564
复制
发表时间：
2006-09-01
期刊：
影响因子：
8
通讯作者：
Lester, Barry M.
中科院分区：
文献类型：
--
作者：
Smith, Lynne M.;LaGasse, Linda L.;Lester, Barry M.
OBJECTIVE.在美国，孕妇使用甲基苯丙胺是一个日益严重的问题。在大规模的前瞻性研究中，尚未报道妊娠期间使用甲基苯丙胺对胎儿生长的影响。我们在一项多中心、纵向的婴儿发育、环境和生活方式研究中研究了产前甲基苯丙胺暴露对新生儿生长的影响。婴儿发育、环境和生活方式研究筛选了4个临床中心的13808名受试者：1618名合格并同意，其中84名暴露于甲基苯丙胺，1534名未暴露。通过自我报告和/或气相色谱-质谱法确认婴儿胎粪中的苯丙胺和代谢物，确定了接触甲基苯丙胺的人。那些未接触安非他明的人否认使用安非他明，胎粪筛查呈阴性。这两组都包括产前酒精，烟草或大麻的使用，但排除了阿片类药物，LSD，PCP或可卡因的使用。新生儿参数包括出生体重和孕周。对不同暴露的出生体重进行了单向方差分析和线性回归分析。使用多元逻辑回归分析来分析甲基苯丙胺暴露与小于胎龄儿发病率的关系。结果。甲基苯丙胺暴露组比未暴露组的胎龄小的可能性高3.5倍。在怀孕期间吸烟的母亲生下小于胎龄儿的可能性几乎高出两倍。此外，母亲在怀孕期间体重增加较少更有可能导致小于胎龄儿。甲基苯丙胺暴露组的体重低于未暴露组。这些发现表明，产前甲基苯丙胺的使用与胎儿生长受限后调整协变量。持续的随访将确定这些婴儿将来是否有生长异常的风险增加。
OBJECTIVE. Methamphetamine use among pregnant women is an increasing problem in the United States. Effects of methamphetamine use during pregnancy on fetal growth have not been reported in large, prospective studies. We examined the neonatal growth effects of prenatal methamphetamine exposure in the multicenter, longitudinal Infant Development, Environment and Lifestyle study.DESIGN/ METHOD. The Infant Development, Environment and Lifestyle study screened 13 808 subjects at 4 clinical centers: 1618 were eligible and consented, among which 84 were methamphetamine exposed, and 1534 were unexposed. Those who were methamphetamine exposed were identified by self-report and/ or gas chromatography-mass spectrometry confirmation of amphetamine and metabolites in infant meconium. Those who were unexposed denied amphetamine use and had a negative meconium screen. Both groups included prenatal alcohol, tobacco, or marijuana use, but excluded use of opiates, LSD, PCP or cocaine only. Neonatal parameters included birth weight and gestational age in weeks. One-way analysis of variance and linear-regression analyses were conducted on birth weight by exposure. The relationship of methamphetamine exposure and the incidence of small for gestational age was analyzed using multivariate logistic-regression analyses.RESULTS. The methamphetamine exposed group was 3.5 times more likely to be small for gestational age than the unexposed group. Mothers who used tobacco during pregnancy were nearly 2 times more likely to have small-for-gestational-age infants. In addition, less maternal weight gain during pregnancy was more likely to result in a small-for-gestational-age infant. Birthweight in the methamphetamine exposed group was lower than the unexposed group.CONCLUSIONS. These findings suggest that prenatal methamphetamine use is associated with fetal growth restriction after adjusting for covariates. Continued follow-up will determine if these infants are at increased risk for growth abnormalities in the future.