Delsing Corinne, Van Den Wittenboer Ellen, Liu Anthony J W, Peek Michael John, Quinton Ann, Mongelli Max, Poulton Alison, Nanan Ralph
Department of Paediatrics, Sydney Medical School - Nepean, The University of Sydney, Penrith, NSW, Australia.
Aust N Z J Obstet Gynaecol. 2011 Oct;51(5):446-51. doi: 10.1111/j.1479-828X.2011.01342.x. Epub 2011 Jul 18.
Opiate and amphetamine use during pregnancy is frequently associated with cigarette smoking. The negative effects on fetal growth from nicotine combined with opiates or amphetamines during pregnancy are not well documented.
To investigate the relationship between maternal opiate or amphetamine use and smoking on fetal growth.
A retrospective study was performed comparing pregnancies affected with either opiates or amphetamines with individually matched controls. All mothers smoked cigarettes during pregnancy. The outcome measures included changes in fetal abdominal circumference, head circumference and femur length during the second half of pregnancy and weight, length and head circumference at birth.
There were 91 opiate- and 37 amphetamine-affected pregnancies. Deviations from normative data only became apparent from the third trimester. The proportion of infants with a gestation-adjusted birthweight below the 10th percentile was not significantly different in the opiate group compared to their controls 35 (38%). However, there was a significant difference in proportions in the amphetamine group and their controls (P < 0.001). We then compared antenatal growth patterns between the amphetamine group and their controls. Amphetamine-exposed fetuses showed comparable growth parameters in the second trimester but significantly larger head and abdominal circumferences and longer femoral lengths in the third trimester than their respective controls (P < 0.05 for all).
When combined with cigarette smoking, opiates had no observed independent effect on birth parameters. Unexpectedly, in the amphetamine group, the negative effects of smoking on growth were altered in late pregnancy.
孕期使用阿片类药物和苯丙胺类药物常常与吸烟有关。孕期尼古丁与阿片类药物或苯丙胺类药物联合使用对胎儿生长的负面影响尚无充分记录。
研究母亲使用阿片类药物或苯丙胺类药物与吸烟对胎儿生长的关系。
进行一项回顾性研究，将受阿片类药物或苯丙胺类药物影响的妊娠与个体匹配的对照组进行比较。所有母亲在孕期都吸烟。观察指标包括孕期后半期胎儿腹围、头围和股骨长度的变化以及出生时的体重、身长和头围。
有91例受阿片类药物影响和37例受苯丙胺类药物影响的妊娠。与标准数据的偏差直到孕晚期才明显。阿片类药物组中，妊娠调整后出生体重低于第10百分位数的婴儿比例与对照组相比无显著差异，为35例（38%）。然而，苯丙胺类药物组与其对照组的比例存在显著差异（P<0.001）。然后我们比较了苯丙胺类药物组与其对照组的产前生长模式。暴露于苯丙胺类药物的胎儿在孕中期生长参数相当，但在孕晚期其头围和腹围显著大于各自对照组，股骨长度也更长（所有P<0.05）。
与吸烟同时存在时，未观察到阿片类药物对出生参数有独立影响。出乎意料的是，在苯丙胺类药物组中，吸烟对生长的负面影响在妊娠后期有所改变。
