RESUMO
Developmental outcomes of infants of drug-dependent mothers (IDDM) who used heroin during preganncy, alone or in combination with methadone, were unfavorable compared with outcomes of infants of mothers who were not drug dependent or infants in the general population. Unfavorable items for IDDM were: gestational age and birth weight, physical growth, neurological development, intelligence, behavior, social competences and social state (foster care). Prenatal care with social support and methadone substitution were critical factors for IDDM. The IDDM in foster care appeared to exhibit even more unfavorable outcomes than those living with their biological parents.
Assuntos
Deficiências do Desenvolvimento/fisiopatologia , Deficiências do Desenvolvimento/psicologia , Dependência de Heroína/complicações , Metadona , Complicações na Gravidez , Transtornos Relacionados ao Uso de Substâncias/complicações , Criança , Filho de Pais com Deficiência , Pré-Escolar , Estudos Transversais , Deficiências do Desenvolvimento/induzido quimicamente , Feminino , Cuidados no Lar de Adoção , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Gravidez , Cuidado Pré-Natal , Fatores de Risco , Apoio SocialRESUMO
In Amsterdam a longitudinal, prospective and multidisciplinary study on the development of infants of drug-dependent mothers (IDDM) was started in 1983: 35 IDDM and 35 reference infants were originally enrolled. The drug-dependent women had used combinations of methadone, heroin, cocaine and other drugs during pregnancy. Of the IDDM, 80% had to be treated pharmaceutically for neonatal abstinence symptoms (NAS). Physical, neurological, cognitive and the socio-emotional development of the children were studied regularly from birth until 5.5 years of age. Differences between the reference group and the IDDM were found most clearly in cognitive development. The IDDM also had more behavioural problems at some of the ages studied. No group differences were seen in motor development. So far the results of the study show that IDDM and their caregivers need extra support in order to improve early communication and the children's cognitive development.
Assuntos
Cocaína , Deficiências do Desenvolvimento , Dependência de Heroína/complicações , Metadona , Complicações na Gravidez , Transtornos Relacionados ao Uso de Substâncias/complicações , Estudos de Casos e Controles , Criança , Filho de Pais com Deficiência , Pré-Escolar , Deficiências do Desenvolvimento/induzido quimicamente , Deficiências do Desenvolvimento/fisiopatologia , Deficiências do Desenvolvimento/psicologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Síndrome de Abstinência Neonatal , Gravidez , Estudos Prospectivos , Fatores de RiscoAssuntos
Desenvolvimento Infantil , Síndrome de Abstinência Neonatal/terapia , Complicações na Gravidez , Transtornos Relacionados ao Uso de Substâncias/complicações , Pré-Escolar , Feminino , Humanos , Lactente , Cuidado do Lactente , Recém-Nascido , Metadona/uso terapêutico , Países Baixos , Formulação de Políticas , Gravidez , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológicoRESUMO
Neurobehavioural development of 35 infants of drug dependent mothers was compared with the development of 37 reference infants as part of a prospective longitudinal research project. Infants of drug dependent mothers had more poor responses than the other children on neurological examination. This difference is significant only when data of infants of drug dependent mothers born at full term are analysed. Two tailed testing indicated that significantly more infants of drug dependent mothers than reference children had electro-encephalograms rated as suspect or abnormal. By the end of the first month the infants of drug dependent mothers tended to be more active, and they had worse scores than the reference children on the neonatal behavioural assessment scale. Analysing data only of infants born at full term, the groups differ significantly on the interactive items. The results of this study show that even after treatment for the neonatal abstinence syndrome, infants of drug dependent mothers seem to differ from comparison children, which could indicate later developmental problems.
Assuntos
Deficiências do Desenvolvimento/etiologia , Complicações na Gravidez , Transtornos Relacionados ao Uso de Substâncias/complicações , Criança , Comportamento Infantil , Pré-Escolar , Eletroencefalografia , Feminino , Habituação Psicofisiológica , Humanos , Drogas Ilícitas/efeitos adversos , Lactente , Recém-Nascido , Estudos Longitudinais , Metadona/efeitos adversos , Atividade Motora , Síndrome de Abstinência Neonatal , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Estudos Prospectivos , Reflexo , Fatores de RiscoRESUMO
Presented are the results over a 4-year period of the conservative management of cases of premature rupture of the membranes. Perinatal mortality in infants delivered more than 24 hours after rupture of the membranes is not higher than that in infants delivered within 24 hours of rupture of the membranes, if these results are based on pregnancies of comparable gestational age. Two independent factors influence the risk of infection: the duration of gestation, and the interval between vaginal examination and delivery. If corrections are made for these two factors, there appears to be no clear correlation between the incidence of infection and the period of time the membranes have been ruptured. Conservative management is justified if vaginal examination is avoided until delivery within 24 hours is expected to occur.