Lumeng Julie C, Cabral Howard J, Gannon Katherine, Heeren Timothy, Frank Deborah A
Center for Human Growth and Development, University of Michigan, Ann Arbor, MI 48109, USA.
Neurotoxicol Teratol. 2007 Jul-Aug;29(4):446-57. doi: 10.1016/j.ntt.2007.02.004. Epub 2007 Mar 12.
Two hundred and two primarily African American/Caribbean children (classified by maternal report and infant meconium as 38 heavier, 74 lighter and 89 not cocaine-exposed) were measured repeatedly from birth to age 8 years to assess whether there is an independent effect of pre-natal cocaine exposure on physical growth patterns. Children with fetal alcohol syndrome identifiable at birth were excluded. At birth, cocaine and alcohol exposures were significantly and independently associated with lower weight, length and head circumference in cross-sectional multiple regression analyses. The relationship over time of pre-natal exposures to weight, height, and head circumference was then examined by multiple linear regression using mixed linear models including covariates: child's gestational age, gender, ethnicity, age at assessment, current caregiver, birth mother's use of alcohol, marijuana and tobacco during the pregnancy and pre-pregnancy weight (for child's weight) and height (for child's height and head circumference). The cocaine effects did not persist beyond infancy in piecewise linear mixed models, but a significant and independent negative effect of pre-natal alcohol exposure persisted for weight, height, and head circumference. Catch-up growth in cocaine-exposed infants occurred primarily by 6 months of age for all growth parameters, with some small fluctuations in growth rates in the preschool age range but no detectable differences between heavier versus unexposed nor lighter versus unexposed thereafter.
202名主要为非裔美国/加勒比裔儿童（根据母亲报告和婴儿胎粪分为38名受可卡因影响较重、74名受影响较轻和89名未接触可卡因）从出生到8岁接受了多次测量，以评估产前可卡因暴露对身体生长模式是否有独立影响。出生时可识别出患有胎儿酒精综合征的儿童被排除在外。在出生时，在横断面多元回归分析中，可卡因和酒精暴露与较低的体重、身长和头围显著且独立相关。然后，使用包括协变量的混合线性模型，通过多元线性回归研究产前暴露与体重、身高和头围随时间的关系：儿童的胎龄、性别、种族、评估年龄、当前照料者、生母在孕期和孕前使用酒精、大麻和烟草的情况以及孕前体重（用于儿童体重）和身高（用于儿童身高和头围）。在分段线性混合模型中，可卡因的影响在婴儿期之后不再持续，但产前酒精暴露对体重、身高和头围有显著且独立的负面影响。接触可卡因的婴儿的追赶性生长主要在6个月大时出现在所有生长参数上，在学龄前年龄范围内生长速率有一些小波动，但此后受影响较重与未接触者之间以及受影响较轻与未接触者之间均未发现可检测到的差异。
