Perinatal outcome of infants exposed to cocaine and/or heroin in utero

Article Abstract:

Women of childbearing age currently abuse cocaine more often than heroin, but many of these women have used both drugs during their pregnancies. Eighty-six infants were studied; their mothers had abused cocaine and/or heroin during pregnancy. The infants were examined for the physical and behavioral effects of these drugs, and the effectiveness of testing the urine of both mother and baby was also assessed. It was found that in about half of the cases there was a discrepancy between the mother's and the baby's urine test results. Of the 35 babies whose mothers used cocaine, 17 percent had a small head or microcephaly, and 27 percent had growth retardation. Microcephaly also occurred in the group of 17 babies exposed to both cocaine and heroin before birth. Signs of drug withdrawal were observed in all infants. Severe withdrawal requiring treatment occurred in 6 percent of babies in the cocaine group, 14 percent in the heroin group, and 35 percent in the cocaine/heroin group. There were 20 cases in which the mother admitted to using cocaine during pregnancy but neither the baby nor the mother tested positive for the drug; in this group 5 percent of infants were treated for severe withdrawal. It is concluded that although the withdrawal symptoms are typically mild after prenatal exposure to cocaine and heroin, they do occur in a significant number of babies. Prenatal abuse of both drugs significantly increased the chances that the baby would experience withdrawal, and also increased the severity of symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Medical examination, Infants (Newborn), Neonatal screening, Drug withdrawal symptoms, Substance withdrawal syndrome

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Brain and ocular abnormalities in infants with in utero exposure to cocaine and other street drugs

Article Abstract:

The use of street drugs, especially cocaine, is becoming an increasingly more significant social and medical problem. Cocaine abuse has escalated in recent years, and the use of cocaine during pregnancy is much more common than other frequently abused drugs. Both pregnancy outcome and fetal development may be affected by cocaine. Ten infants with abnormal brain structures and neurologic abnormalities are described. All 10 infants were exposed to cocaine or other drugs during the first trimester. One was exposed to amphetamine through most of the pregnancy, one was exposed to diet pills containing the stimulant phenylpropanolamine up through the 12th week of gestation, and one was exposed to heroin through most of the pregnancy. The remaining seven infants were exposed to cocaine through part or most of their development in the uterus. All infants had some degree of developmental delay in mental and motor skills, but the severity varied. Most had increased muscle tone and some spasticity. All patients had ataxia (poor coordination) of the trunk, usually manifested by poor head control. Five patients had seizures. Nine patients had ophthalmological abnormalities such as strabismus (eyes that cannot focus together), delay in developing visual fixation, or blindness. A variety of brain malformations were found by imaging with computed tomography (CT) or magnetic resonance imaging (MRI). The type of abnormality and time of prenatal drug exposure appeared to be related. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Causes of, Complications and side effects, Diseases, Birth defects, Infants (Premature), Premature infants, Brain, Eye, Ataxia, Phenylpropanolamine, Adrenergic alpha-agonists

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Unsuspected cocaine exposure in young children

Article Abstract:

Although much is now known concerning the effects of cocaine exposure during the prenatal period, less has been discovered about the effects of this drug on young children. Children can ingest cocaine with breast milk or accidentally, or can be given the drug intentionally. They may also passively inhale crack vapors or cocaine in household dust. To learn more about the prevalence of cocaine exposure in young children, a study was carried out of children aged two weeks to five years who were brought to a pediatric emergency department of an inner-city hospital during a six-week period. If parents consented to their children being studied for exposure to environmental toxins, urine samples were obtained and analyzed for cocaine and its metabolites (mainly, benzoylecgonine). Children who showed signs of cocaine exposure were not included. The results for 250 patients (59 percent, boys; 53 percent, black) showed that 6 (2.4 percent) tested positive for benzoylecgonine. Four of these children were younger than one year, and all were younger than two years. Only one was breast-fed at the time. It is likely that this rate of positive tests was a consequence of the cocaine usage rates among these children's caretakers. The children did not have signs of cocaine exposure, and they thus present a special problem for policy makers. The number of asymptomatic young children and infants who are exposed to this drug is undoubtedly large, and the issue should be addressed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Children, Social policy, Mandatory drug testing, Drug testing

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