Schiller Cassandra, Allen Pat Jackson
Yale University School of Nursing, New Haven, CT, USA.
Pediatr Nurs. 2005 Sep-Oct;31(5):427-36.
Maternal cocaine use during pregnancy continues to be of great concern for health care professionals. Research in this area has increased as investigators examine the effects of prenatal cocaine exposure in the infant/young child. This paper will critically review the literature, identify the primary care needs of infants and young children with a known history of prenatal cocaine exposure, and present guidelines for the primary care practitioner to monitor the infant's physiologic and developmental sequelae during the first 3 years of life. Findings in the literature demonstrate inconsistencies in regard to the physiologic and developmental outcomes of infants/young children prenatally exposed to cocaine. Further research is warranted, as it is evident from studies that not all investigators are controlling for confounding variables such as poly-drug use, which is necessary in isolating cocaine's effects. Subtle effects, however, have been reported from well-controlled studies and, thus, particular attention needs to be paid to early identification and interventions by primary care practitioners to prevent negative health outcomes. The guidelines proposed assist the practitioner with a thorough and focused approach to assessing the physiologic and developmental effects that are currently known to occur in the infant/young child prenatally exposed to cocaine.
孕期母亲使用可卡因仍然是医护人员极为关注的问题。随着研究人员对婴儿/幼儿产前接触可卡因的影响进行研究，该领域的研究有所增加。本文将对相关文献进行批判性综述，确定有产前可卡因接触史的婴幼儿的主要护理需求，并为初级保健从业者提供指导方针，以监测婴儿在生命最初3年的生理和发育后遗症。文献中的研究结果表明，在产前接触可卡因的婴幼儿的生理和发育结果方面存在不一致之处。鉴于研究表明并非所有研究人员都在控制诸如多药使用等混杂变量（而这对于分离可卡因的影响是必要的），因此有必要进行进一步研究。然而，从严格控制的研究中已经报告了一些细微的影响，因此，初级保健从业者需要特别注意早期识别和干预，以防止出现负面健康结果。所提出的指导方针有助于从业者采用全面且有重点的方法来评估目前已知在产前接触可卡因的婴幼儿中出现的生理和发育影响。
