Perinatal outcome after recent cocaine usage

Article Abstract:

Cocaine use during pregnancy has been associated with a poor pregnancy outcome, including early separation of the placenta (abruptio placentae), congenital abnormalities, early labor, low birth weight and small head size. Cocaine in the mother's blood crosses the placenta easily to enter the circulation of the fetus. The enzyme responsible for clearing cocaine from the body is normally reduced during pregnancy and is generally low in the fetus as well. Cocaine used three days prior to delivery continues to be detected in the urine of the fetus up to four days after delivery. The outcome of pregnancy after recent cocaine exposure, within one week of the delivery, is reported for 88 cocaine-exposed infants. The urine from 40 infants was positive for by-products of cocaine metabolism, while 46 infants tested negative. The infants who tested positive were more likely to be involved in early labor, premature rupture of the membranes surrounding the fetus and meconium-stained amniotic fluid (the first fetal stool released during a stressful event during pregnancy). Infants who tested positive were also more likely to exhibit signs and symptoms of cocaine intoxication, such as a high-pitched cry, seizures, sweating, tremulousness, increased responsiveness, and rapid heart beats. Although there was a trend towards lower birth weights, abruptio placentae and growth retardation in the group of infants testing positive for cocaine when compared with the normal population, the difference between the two study groups was not significant. It is difficult to interpret the results of this study since the exact dosages, the frequency of use and the age of the fetus when exposed were not known. The group of infants testing positive may represent a subgroup of infants who experience sudden changes rather than changes over a period of time. A negative result may not necessarily mean the infant was cocaine-free but rather may have been exposed only a few days prior to delivery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Fetus, Pregnancy, Complications of, Pregnancy complications, Cocaine

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Brain growth among fetuses exposed to cocaine in utero: Asymmetrical growth retardation

Article Abstract:

Retarded, or slowed, growth patterns in fetuses are characterized by decreased weight, length, and head circumference at birth. These features are often seen in infants born to women who drink alcohol in pregnancy and may also be associated with cocaine use during pregnancy. Measurements of head circumference, birth weight, and gestational age were collected from the medical records of 247 infants born to women who: used cocaine, but not alcohol (80 infants); used alcohol, but not cocaine (67 infants); or used neither cocaine nor alcohol (100 infants). The goal was to determine the effect of cocaine exposure on the brain development of the fetus. The average gestational age of the infants in all three groups was not different, but the birth weight, length and circumference of the head were different (smaller) in the alcohol- and cocaine-exposed infants than the unexposed infants. However, these factors were not different between the alcohol- and cocaine-exposed groups. The authors suggest that fetal growth retardation may be associated with cocaine use, as has been reported for maternal alcohol use during pregnancy. As is true for fetuses exposed to alcohol, fetuses exposed to cocaine had asymmetrical growth retardation, meaning that head circumference was more severely reduced than birth weight; this indicates that brain growth is retarded more than body growth. All cocaine-exposed infants should be evaluated for possible brain abnormalities. (Consumer Summary produced by Reliance Medical Information, Inc.)

Pregnant women, Drug use, Fetal brain

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Correlation of neonatal nucleated red blood cell counts in preterm infants with histologic chorioamnionitis

Article Abstract:

Infections in sections of the placenta called the chorion and the amnion may cause an increase in the infants' nucleated red blood cell count. Nucleated red blood cells in infants are a sign of increased red blood cell production and can be a sign of fetal oxygen deficit. Nucleated red blood cell counts were measured in 359 premature infants. Mothers with evidence of infection as determined by microscopic examination of placental tissue samples were significantly more likely to have infants with elevated nucleated red blood cell counts. In this case, nucleated red blood cells could be a response to the placental infection.

Measurement, Infants (Premature), Premature infants, Erythrocytes, Red blood cells, Chorioamnionitis

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