COCAINE EXPOSED INFANTS--CARDIAC PROBLEMS AND OUTCOME

怀孕期间使用可卡因的母亲所生的婴儿 发病率更高。初步观察表明， 多发性心血管异常，如左心室大 大量人群、持续性高血压、ST段抬高 抬高(提示跨壁缺血)和更高的迷走神经张力。 在无症状的可卡因中观察到了这些异常 在生命的头两天暴露的新生儿。要确定 宫内可卡因暴露对新生儿心血管的影响 拟议的研究有以下目的：目的：L--检测 新生儿期的心血管异常；目标2-至 在前两个阶段研究这些异常的自然历史 几个月的生命。一组无症状婴儿(n=420)将 在新生儿托儿所学习。接触可卡因或不接触可卡因 将由孕妇尿液筛查阳性和 临床面谈，并将通过毒理学研究证实 婴儿尿液或胎粪。研究对象将分为 三组。L组包括接触可卡因的新生儿 在怀孕期间；因为广泛同时使用 在这些母亲中，吸烟、吸烟和吸食大麻， 这些婴儿将被归入L组。为了划定 可卡因对心血管的影响，他们的数据将与 另外两组：第二组将包括新生儿 子宫暴露于酒精、香烟和/或吸食大麻。 接触其他药物的受试者，包括可卡因，将是 被排除在此组之外。第三组包括对照新生儿 在胎儿时期没有接触过任何药物的婴儿。出生时 在两个月大的时候，所有的婴儿都将接受两次评估- 三维和多普勒超声心动图，3导联动态心电图 ST段抬高监测仪与心脏频谱分析 经期和血压测量。的相互关系 这些异常及其对婴儿发病率的影响将是 下定决心。这些异常的持续存在可能提供一个 洞察这些患者的长期发病率。因此，它 对于理解心血管疾病的自然历史至关重要。 在采取措施针对他们的 治疗和预防。

Infants born to mothers who use cocaine during pregnancy have greater morbidity. Preliminary observations suggest the presence of multiple cardiovascular abnormalities such as greater left ventricular mass, persistent hypertension, greater prevalence of ST segment elevations (suggesting transmural ischemia) and higher vagal tone. These abnormalities were observed in asymptomatic cocaine exposed newborns during the first 2 days of life. To determine the cardiovascular effects of in-utero cocaine exposure on newborns, the proposed study has following aims: Aim l - To detect the cardiovascular abnormalities in the newborn period; Aim 2 - To study the natural history of these abnormalities during the first 2 months of life. A cohort of asymptomatic infants (n=420) will be studied in the newborn nursery. Cocaine exposure or nonexposure will be determined by the positive maternal urine screening and clinical interview and will be substantiated by toxicology studies of infants urine or meconium. The study subjects will be divided into three groups. Group l includes newborn infants exposed to cocaine during pregnancy; because of the widespread concurrent use of alcohol, cigarette and marijuana smoking among these mothers, these infants will be included under Group l. To delineate the cardiovascular effects of cocaine, their data will be compared with two other groups: Group II will include newborn infants with in utero exposure to alcohol, cigarette and/or marijuana smoking. Subjects exposed to other drugs, including cocaine, will be excluded from this group. Group III includes control newborn infants who are not exposed to any drugs during fetal life. At birth and at 2 months of age, all infants will be evaluated by two- dimensional and Doppler echocardiograms, 3 channel Holter monitors for ST segment elevations and spectral analysis of heart period, and blood pressure measurements. The inter-relationship of these abnormalities and their effect on infant morbidity will then be determined. Persistence of these abnormalities may provide an insight into the long term morbidity of these patients. Therefore, it is crucial to understand the natural history of the cardiovascular abnormalities before measures can be directed toward their treatment and prevention.