Wayne State University School of Medicine, Detroit, Michigan, USA.
J Hypertens. 2010 Jun;28(6):1166-75.
Prenatal cocaine exposure has been linked to intrauterine growth retardation and poor birth outcomes; little is known about the effects on longer-term medical outcomes, such as overweight status and hypertension in childhood. Our objective was to examine the association between prenatal cocaine exposure and BMI and blood pressure at 9 years of age among children followed prospectively in a multisite longitudinal study evaluating the impact of maternal lifestyle during pregnancy on childhood outcome.
DESIGN/METHODS: This analysis includes 880 children (277 cocaine exposed and 603 with no cocaine exposure) with blood pressure, height, and weight measurements at 9 years of age. Regression analyses were conducted to explore the relationship between prenatal cocaine exposure and BMI and blood pressure at 9 years of age after controlling for demographics, other drug exposure, birthweight, maternal weight, infant postnatal weight gain, and childhood television viewing, exercise, and dietary habits at 9 years. Path analyses were used to further explore these relationships.
At 9 years of age, 15% of the children were prehypertensive and 19% were hypertensive; 16% were at risk for overweight status and 21% were overweight. A small percentage of women were exposed to high levels of prenatal cocaine throughout pregnancy. A higher BMI was noted in children born to these women. Path analysis suggested that high cocaine exposure has an indirect effect on systolic and diastolic blood pressures that is mediated through its effect on BMI.
High levels of in-utero cocaine exposure are a marker for elevated BMI and blood pressure among children born full term.
产前可卡因暴露与宫内生长迟缓及不良出生结局有关；但对于其对儿童期超重和高血压等长期医疗结局的影响，人们知之甚少。我们的目的是研究在一项多中心纵向研究中，前瞻性随访的儿童中，产前可卡因暴露与 BMI 和 9 岁时血压之间的关系，该研究评估了孕期母体生活方式对儿童结局的影响。
方法/设计：本分析纳入了 880 名儿童（277 名可卡因暴露，603 名无可卡因暴露），他们在 9 岁时进行了血压、身高和体重测量。回归分析用于探索在控制人口统计学、其他药物暴露、出生体重、母亲体重、婴儿产后体重增加、儿童 9 岁时的电视观看、运动和饮食习惯后，产前可卡因暴露与 9 岁时 BMI 和血压之间的关系。路径分析用于进一步探讨这些关系。
在 9 岁时，15%的儿童处于高血压前期，19%的儿童患有高血压；16%的儿童超重风险增加，21%的儿童超重。一小部分妇女在整个孕期都接触到高水平的产前可卡因。这些妇女所生的儿童 BMI 较高。路径分析表明，高可卡因暴露对收缩压和舒张压有间接影响，这种影响是通过其对 BMI 的影响介导的。
宫内可卡因暴露水平高是足月出生儿童 BMI 和血压升高的一个标志。
