Gingras J L, Weese-Mayer D E, Hume R F, O'Donnell K J
Department of Pediatrics, Duke University Medical Center, Durham, NC 27710.
Early Hum Dev. 1992 Nov;31(1):1-24. doi: 10.1016/0378-3782(92)90011-5.
As cocaine use during pregnancy has become increasingly recognized, there also has been increased concern about the toxic and teratogenic properties of cocaine on the fetus. A significant literature exists describing the adverse fetal and neonatal outcomes associated with in utero cocaine exposure. However, specific causality by cocaine on outcome in the human is difficult to ascertain because of multiple confounding variables associated with substance abuse including social factors and polydrug use as well as difficulty in confirming timing, dose and frequency of cocaine exposure. Most literature suggests that prenatal cocaine exposure is associated with developmental risk to the fetus. What is currently unknown is the extent of risk, the additive and/or synergistic factors contributing to cocaine's toxicity and the reversibility of the injury. In this paper we review the pharmacologic properties of cocaine as related to a model of mechanisms for developmental injury secondary to cocaine exposure and the published literature on the adverse fetal and neonatal outcomes associated with cocaine use during pregnancy. Specific attention has been focused on the structural, neurobehavioral and respiratory control teratogenesis.
随着孕期使用可卡因的情况日益受到关注，人们对可卡因对胎儿的毒性和致畸特性也愈发担忧。现有大量文献描述了与子宫内可卡因暴露相关的不良胎儿和新生儿结局。然而，由于与药物滥用相关的多个混杂变量，包括社会因素、多药使用，以及难以确定可卡因暴露的时间、剂量和频率，很难确定可卡因对人类结局的具体因果关系。大多数文献表明，产前可卡因暴露与胎儿发育风险相关。目前尚不清楚的是风险程度、导致可卡因毒性的相加和/或协同因素，以及损伤的可逆性。在本文中，我们回顾了可卡因的药理特性，这些特性与可卡因暴露继发发育损伤的机制模型相关，以及关于孕期使用可卡因相关的不良胎儿和新生儿结局的已发表文献。特别关注了结构、神经行为和呼吸控制致畸作用。
