Elevated plasma norepinephrine levels in infants of substance-abusing mothers

Article Abstract:

In the United States today about 15 percent of women of childbearing age use illegal drugs. Babies born to these mothers have a significant number of growth and developmental abnormalities, and are at increased risk for sudden infant death syndrome and breathing pattern abnormalities. It is not known how exposure of the fetus to cocaine or opiates (such as heroin) causes these problems. Pharmacologically the drug cocaine blocks the reuptake of monoamines (including norepinephrine). This produces depletion of neurotransmitters and causes extreme sensitivity of catecholamine receptors. Catecholamine is a substance that mimics stimulation by the sympathetic nerves; this is achieved by occupying receptor sites and acting as an antagonist or by increasing the release of a neurotransmitter. Opiate addiction and subsequent withdrawal causes changes in the catecholamine neurotransmitter and receptor function in the brain. It is hypothesized by that babies born to mothers who use drugs have increased tone of the sympathetic nervous system, and changes in the catecholamine levels. Levels of norepinephrine in the blood were measured in 22 apparently healthy babies who were born to substance-abusing mothers and in 15 normal babies with mothers who were not abusing drugs. The babies averaged between 2.1 and 2.5 months of age. The norepinephrine levels were 1.8 times as high in the group of babies born to substance-abusing mothers than in the control group. This finding may be associated with the increased nervous system tone that is observed in these babies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Substance abuse, Narcotics, Noradrenaline, Norepinephrine

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Occult cocaine exposure in children

Article Abstract:

Cocaine has become one of the most widely abused illicit drugs. Consequently, cocaine exposure among certain pediatric groups, including adolescents, breast-fed infants, and newborns of addicted mothers, has risen. Other infants and toddlers may also be at risk, possibly due to accidental ingestion or passive inhalation of vapors. To understand the prevalence of occult (hidden or asymptomatic) exposure to cocaine in young children, urine levels of cocaine metabolites (breakdown products) were analyzed in 460 children, aged 1 to 60 months. The children were treated in an urban hospital emergency department for a variety of problems that required a urine specimen be obtained. A cocaine metabolite was detected by 2 tests in the urine samples of 25 patients, and confirmed by a third test in 8 of 8 samples. One sample also contained intact cocaine; no marijuana-related product was found. The presence of cocaine metabolite was not related to age, history of breast-feeding, interference by other medications, or day of the week. Patients resided in 78 zip code areas, and although the positive samples were from 13 areas, they were concentrated in 3 zip code regions. As indications of other exposures were absent, it is possible that the children passively inhaled vapors while adults were smoking free-base cocaine. The risks of such environmental exposure are unclear, but potential effects of long-term low-level exposure on child development require further study and should be evaluated by primary-care physicians. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Cocaine

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Social and medical problems in children of heroin-addicted parents

Article Abstract:

The social and medical problems of 75 children of intravenous heroin-addicted parents were assessed between January 1985 and December 1987. The children ranged between 4 days and 14 years of age and suffered from serious childhood diseases. The problems identified in these children were classified into three groups: infectious diseases, nutritional diseases, and parental neglect and/or disinterest. Common conditions included gastroenteritis or inflammation of the stomach and intestines in 24 percent of children; pneumonia in 21 percent; malnutrition in 17 percent; infection of the upper airways in 13 percent; bacterial infection of the blood in 12 percent; child abuse in 4 percent; AIDS in 3 percent; and other types of infections in 24 percent. In addition to heroin addiction, diseases that were reported in parents included infection with hepatitis B virus, AIDS, and alcoholism. Thirty-seven percent of fathers were not employed, and 19 percent of parents had been in prison. Children of intravenous heroin-addicted parents should be managed by a multidisciplinary approach to prevent disease and to decrease the costs of health care. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Causes of, Drug addicts, Family, Drug abuse, Heroin habit, Parental rejection

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