MATERNAL CRACK USE: PERINATAL AND INFANCY EFFECTS

在过去的几年里，虐待行为急剧增加 怀孕人口中的可卡因。除了裂缝之外，你还是一个 30%-35%的人滥用其他非法药物。有越来越多的数据关于 可卡因对围产儿的影响，但关于可卡因的信息很少 裂缝的影响。该提案的总体目的是调查 产前滥用精神分裂症对妊娠及早期躯体发育的影响 婴幼儿的神经行为发育。总共426个 孕妇将参加这项研究：65%的孕妇有吸毒史 有35%的人将不再吸毒。将涵盖三个时间段： 孕期、新生儿、婴儿期至2岁。怀孕期间的数据将是 收集关于裂缝的使用情况，包括数量、路线、频率。使用 其他滥用药物的情况将会被注意到。这将通过药物摄取来完成 定期进行问卷调查和尿液药物筛查。数据在 关于感染的过去和现在的医学和产科信息， 产科并发症、产程和分娩过程、营养和 体重增加，胎儿健康，使用胎心率监测和 我们会收集超声仪。新生儿将有一个身体和 神经学检查。头颅超声对R/O先天畸形的诊断 可卡因中毒症状评分。布拉斯尔顿神经行为 将进行评估，以评估早期响应能力。图表 将对相关数据进行审查。所有婴儿都将参加 后续行动。 婴儿健康评估计划(IHAP)最近在纽约市成立 其任务是跟踪并确保向高危人群提供全面护理 有风险的婴儿。我们将与IHAP合作，确保出席 后续诊所。孩子们将在6个月、12个月、18个月和24个月大的时候出现。 以确定生理和神经生长参数的异常 每次访问都将进行评估。标准衡量标准 认知和知觉发展将被用来确定 发育和行为障碍。确定是否存在任何赤字 沟通和社交技能标准措施和母婴 将使用互动。产妇的人口统计和心理社会数据将 在出生前和出生后收集。吸毒的影响，母体 心理社会功能、产前和新生儿病程与母婴 相互作用将根据躯体和神经发育结果进行检查。 婴儿的数量。这些信息将为建议提供基础 用于医疗保健和干预计划，以将风险降至最低 神经行为和发育问题。

During the past few years there has been a tremendous increase in the abuse of crack in the pregnant population. In addition to the crack thee is a 30-35% abuse of other illicit drugs. There is a growing body of data on the perinatal effects of cocaine but very little information exists on the effects of crack. The overall purpose of the proposal is to investigate the effects of prenatal crack abuse on pregnancy and the early somatic and neurobehavioral development of the infant and young child. A total of 426 pregnant women will be enrolled in the study: 65% with a history of crack abuse; and 35% will be drug-free. Three time periods will be covered: gestation, neonatal, and infancy to 2 years. During pregnancy data will be collected on the use of crack including number, route, frequency. Use of other drugs of abuse will be noted. this will be done using drug intake questionnaires and urinary drug screens at frequent intervals. Data on past and present medical and obstetrical information as to infections, obstetrical complications, course of labor and delivery, nutrition and weight gain, fetal well being using fetal heart rate monitoring and ultrasonography will be collected. The neonate will have a physical and neurological exam. USG of the head to R/O congenital anomalies, and a cocaine intoxication symptom score. The Brazelton Neurobehavioral Assessment will be administered to evaluate early responsiveness. Charts will be reviewed for pertinent data. All infants will be enrolled in follow-up. The Infant Health Assessment Program (IHAP) was recently established in NYC with a mandate to track and ensure provision of comprehensive care to high risk infants. We will collaborate with the IHAP to ensure attendance at the follow-up clinic. The children will be seen at 6,12,18, and 24 months. To determine abnormalities growth para-meters, physical and neurological evaluations will be performed at each visit. Standard measures of cognitive and perceptual development will be administered to determine developmental and behavioral difficulties. To determine any deficits in communication and social skills standard measures and mother-infant interaction will be used. Maternal demographic and psychosocial data will be collected pre-and postnatally. The effects of crack use, maternal psychosocial functioning, prenatal and neonatal course, and mother infant interaction will be examined on the somatic and neurodevelopmental outcome of the infants. This information will provide a basis for recommendations for health care and intervention programs to minimize the risk for neurobehavioral and developmental problems.