Patterns of growth and development in narcotic-exposed children.

The results of the studies reviewed indicate that intrauterine growth is adversely affected by drug use during pregnancy. Whether the impairment is a direct effect of narcotic exposure or is the result of the interaction of deleterious health, environmental, and socioeconomic factors closely associated with the lifestyle of the woman who abuses drugs cannot be determined at present. Reports on the long-term effects of drug use on growth and intellectual functioning in the offspring of women who abuse drugs are not consistent. While some studies indicate that most of the exposed infants exhibit catchup growth by 6 months of age (Lifschitz et al. 1983, 1985), one methodologically strong study suggests that methadone may have a small direct teratogenic effect reflected in reduced head size at 2 years of age (Hans 1989). Unexplained is the pattern of growth deceleration observed in some narcotic-exposed children (Lifschitz et al. 1983, 1985). The few available reports on long-term outcome concur that narcotic-exposed children have a high incidence of behavioral and learning problems (Strauss et al. 1979; Rosen and Johnson 1985; Wilson 1989), but population studies have been too small to demonstrate that they differ significantly from controls. There is a suggestion that narcotic use during pregnancy promotes a biological vulnerability to adverse environments, manifested in the neurobehavioral and intellectual areas.