Prenatal methamphetamine use and neonatal neurobehavioral outcome
Prenatal methamphetamine use and neonatal neurobehavioral outcome
复制标题
DOI：
10.1016/j.ntt.2007.09.005
复制
发表时间：
2008-01-01
影响因子：
2.9
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.
背景：在美国，孕妇使用甲基苯丙胺 (MA) 的问题日益严重。产前 MA 暴露如何影响新生儿神经行为尚不清楚。目的：检查产前 MA 暴露对神经行为的影响。设计：婴儿发育、环境和生活方式 (IDEAL) 研究筛选了 13,808 名受试者，其中 1632 名受试者符合资格并同意。 166 名（n = 74 名暴露者）被纳入纵向随访。通过胎粪测定和自我报告来确定两组中存在的酒精、大麻和烟草的暴露情况。 NICU 网络神经行为量表 (NNNS) 在出生后 5 天内进行。对 NNNS 总结评分进行的分析包括暴露组效应、大量 MA 使用效应、与妊娠期使用频率的关联以及与安非他明代谢物的剂量反应关系。结果：调整协变量后，MA 暴露与生理应激增加相关。大量使用 MA 与较低的唤醒度、更嗜睡和增加的生理压力有关。妊娠早期 MA 的使用与压力戒断程度的提高有关。妊娠晚期的使用与运动质量较差有关。胎便中较高水平的苯丙胺代谢物与中枢神经系统应激增加有关。结论：产前接触苯丙胺与觉醒降低、压力增加和运动质量差等神经行为模式相关。剂量-反应关系可能代表 MA 的神经毒性作用。 (c) 2007 Elsevier Inc. 保留所有权利。
Background: Methamphetamine (MA) use among pregnant women is an increasing problem in the United States. How prenatal MA exposure affects neonatal neurobehavior is unknown.Objective: To examine the neurobehavioral effects of prenatal MA exposure.Design: The Infant Development, Environment and Lifestyle (IDEAL) study screened 13,808 subjects and 1632 were eligible and consented. 166 (n = 74 exposed) were enrolled in a longitudinal follow-up. Exposure was determined by meconium assay and self-report with alcohol, marijuana, and tobacco present in both groups. The NICU Network Neurobehavioral Scale (NNNS) was administered within the first 5 days of life. Analyses conducted on NNNS summary scores included exposure group effects, heavy MA use effects, association with frequency of use by trimester, and dose-response relationships with amphetamine metabolites.Results: After adjusting for covariates, exposure to MA was associated with increased physiological stress. Heavy MA use was related to lower arousal, more lethargy, and increased physiological stress. First trimester MA use was related to elevated stress abstinence. Third trimester use was related to poorer quality of movement. Higher level of amphetamine metabolites in meconium was associated with increased CNS stress.Conclusions: Prenatal MA exposure was associated with neurobehavioral patterns of decreased arousal, increased stress, and poor quality of movement. The dose-response relationships may represent neurotoxic effects from MA. (c) 2007 Elsevier Inc. All rights reserved.