Neurological correlates of fetal cocaine exposure: transient hypertonia of infancy and early childhood.
Pediatrics
; 96(6): 1070-7, 1995 Dec.
Article
en En
| MEDLINE
| ID: mdl-7491223
ABSTRACT
OBJECTIVE:
To assess whether prenatal cocaine exposure has any long-term effects on neurodevelopment.DESIGN:
A prospective cohort study with examiners blind to drug exposure and human immunodeficiency virus (HIV) status.SUBJECTS:
Of 144 high-risk infants enrolled in a perinatal HIV neurodevelopmental study, 119 (83%) infants with both neurological and urine toxicology measures were followed up to age 24 months.METHODS:
Neurological and developmental assessments were analyzed at 6-month intervals grouped according to the presence of cocaine in urine toxicology 51 infants were cocaine-positive. Adjusted odds ratios (ORs) and 95% confidence interval (CI) were obtained by logistic regression equations that adjusted for perinatal variables, including measures of fetal growth, gestation, HIV status, and infant toxicology results.SETTING:
Harlem Hospital Center from 1988 to 1992.RESULTS:
At age 6 months, 21 of 51 (41%) cocaine-positive children exhibited hypertonia of any type (hypertonic tetraparesis, hypertonic diparesis, and hypertonic hemiparesis) compared with 17 of 68 (25%) cocaine-negative infants (OR = 2.1, CI = 1.0-4.6). Cocaine-positive infants were four times more likely to show hypertonic tetraparesis (HTP) than cocaine-negative infants (OR = 4.0; CI = 1.5-10.8). The association remained significant in multivariate analyses. Hypertonia, consistent with cerebral palsy, diminished over time in both groups. In 97% of affected infants hypertonia resolved by 24 months. Arm hypertonia abated first; leg hypertonia remained in some children up to age 18 months. No differences in development scores between cocaine-positive and cocaine-negative were noted at any age interval. However, among cocaine-positive infants those with early HTP showed significantly lower mean developmental scores at 6 and 12 month compared to infants without HTP.CONCLUSION:
Cocaine positivity urine toxicology at birth is associated with hypertonia during infancy. Such cocaine-induced effects are usually symmetrical, transient, and the majority of exposed children outgrow hypertonia by 24 months of life. Among cocaine-positive infants, HTP may be a marker for later developmental impairments.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Efectos Tardíos de la Exposición Prenatal
/
Cocaína
/
Trastornos Relacionados con Sustancias
/
Hipertonía Muscular
/
Enfermedades del Sistema Nervioso
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
/
Pregnancy
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Pediatrics
Año:
1995
Tipo del documento:
Article
País de afiliación:
Estados Unidos