Bada Henrietta S, Das Abhik, Bauer Charles R, Shankaran Seetha, Lester Barry, Wright Linda L, Verter Joel, Smeriglio Vincent L, Finnegan Loretta P, Maza Penelope L
The University of Kentucky, Lexington, Kentucky 40536, USA.
Obstet Gynecol. 2002 Nov;100(5 Pt 1):916-24. doi: 10.1016/s0029-7844(02)02199-3.
To estimate the effects of cocaine exposure on intrauterine growth and to investigate at what point in gestation growth deviation would be manifested.
This is a secondary analysis of data from a multicenter project, the Maternal Lifestyle Study, designed to determine infant outcomes of in utero cocaine or opiates exposure. Four centers of the National Institute of Child Health and Human Development Neonatal Research Network enrolled 11,811 maternal-infant dyads. A total of 1072 infants were cocaine exposed, 7565 were cocaine negative by maternal history and meconium results, and 3174 were excluded from analysis because of unconfirmed negative exposure. Outcome measures included birth weight, length, and head circumference.
Percentile estimates for birth weight, length, and head circumference revealed growth deceleration in cocaine-exposed infants evident after 32 weeks' gestation. There was significant interaction between cocaine and gestational age. After controlling for confounders, at 40 weeks' gestation, cocaine exposure was estimated to be associated with a decrease of 151 g, 0.71 cm, and 0.43 cm in birth weight, length, and head circumference, respectively. Smoking had a negative impact on all growth measurements, with some indication of a dose-effect relationship. Heavy alcohol use was associated with decrease in weight and length only. Opiates had significant effect only on birth weight.
In utero cocaine exposure is associated with growth deceleration involving all measurements, becoming more pronounced with advancing gestation.
评估可卡因暴露对子宫内生长的影响，并研究生长偏差会在妊娠的哪个阶段表现出来。
这是对一个多中心项目——孕产妇生活方式研究——数据的二次分析，该研究旨在确定子宫内可卡因或阿片类药物暴露的婴儿结局。美国国立儿童健康与人类发展研究所新生儿研究网络的四个中心招募了11811对母婴。共有1072名婴儿有可卡因暴露史，7565名婴儿根据母亲病史和胎粪检测结果为可卡因阴性，另有3174名因暴露情况未得到确认而被排除在分析之外。观察指标包括出生体重、身长和头围。
出生体重、身长和头围的百分位数估计显示，可卡因暴露婴儿在妊娠32周后出现生长减速。可卡因与胎龄之间存在显著交互作用。在控制混杂因素后，在妊娠40周时，估计可卡因暴露分别与出生体重降低151克、身长降低0.71厘米和头围降低0.43厘米有关。吸烟对所有生长指标均有负面影响，且有一定剂量效应关系的迹象。大量饮酒仅与体重和身长降低有关。阿片类药物仅对出生体重有显著影响。
子宫内可卡因暴露与所有测量指标的生长减速有关，且随着妊娠进展愈发明显。
