Kiblawi Zeina N, Smith Lynne M, Diaz Sabrina D, LaGasse Linda L, Derauf Chris, Newman Elana, Shah Rizwan, Arria Amelia, Huestis Marilyn, Haning William, Strauss Arthur, DellaGrotta Sheri, Dansereau Lynne M, Neal Charles, Lester Barry
a LA Biomed Institute at Harbor-UCLA Medical Center and David Geffen School of Medicine , Los Angeles , California , USA.
Subst Abus. 2014;35(1):68-73. doi: 10.1080/08897077.2013.814614.
Methamphetamine (MA) use among pregnant women is an increasing problem in the United States. How MA use during pregnancy affects neonatal and infant neurobehavior is unknown.
The Infant Development, Environment, and Lifestyle (IDEAL) study screened 34,833 subjects at 4 clinical centers. Of the subjects, 17,961 were eligible and 3705 were consented, among which 412 were enrolled for longitudinal follow-up. Exposed subjects were identified by self-report and/or gas chromatography/mass spectroscopy (GC/MS) confirmation of amphetamine and metabolites in meconium. Comparison subjects were matched (race, birth weight, maternal education, insurance), denied amphetamine use, and had a negative meconium screen. Both groups included prenatal alcohol, tobacco, and marijuana use, but excluded use of opiates, lysergic acid diethylamide, or phencyclidine. The Neonatal Intensive Care Unit (NICU) Network Neurobehavioral Scale (NNNS) was administered within the first 5 days of life and again at 1 month to 380 enrollees (185 exposed, 195 comparison). Analysis of variance (ANOVA) tested exposure effects on NNNS summary scores at birth and 1 month. General linear model (GLM) repeated-measures analysis assessed the effect of MA exposure over time on the NNNS scores with and without covariates.
By 1 month of age, both groups demonstrated higher quality of movement (P = .029), less lethargy (P = .001), and fewer asymmetric reflexes (P = .012), with no significant differences in NNNS scores between the exposed and comparison groups. Over the first month of life, arousal increased in exposed infants but decreased in comparison infants (P = .031) and total stress was decreased in exposed infants, with no change in comparison infants (P = .026).
Improvement in total stress and arousal were observed in MA-exposed newborns by 1 month of age relative to the newborn period.
在美国，孕妇使用甲基苯丙胺（MA）的问题日益严重。孕期使用MA如何影响新生儿及婴儿的神经行为尚不清楚。
婴儿发育、环境与生活方式（IDEAL）研究在4个临床中心对34833名受试者进行了筛查。其中17961名符合条件，3705名同意参与，最终412名被纳入纵向随访。通过自我报告和/或胎粪中苯丙胺及其代谢物的气相色谱/质谱（GC/MS）确认来确定暴露组受试者。对照组受试者在种族、出生体重、母亲教育程度、保险情况方面进行匹配，否认使用苯丙胺，且胎粪筛查为阴性。两组均包括产前酒精、烟草和大麻使用情况，但排除使用阿片类药物、麦角酸二乙胺或苯环利定。在出生后的前5天内以及1个月时，对380名入组者（185名暴露组、195名对照组）进行了新生儿重症监护病房（NICU）网络神经行为量表（NNNS）测评。方差分析（ANOVA）检验了出生时及1个月时暴露对NNNS总分的影响。一般线性模型（GLM）重复测量分析评估了MA暴露随时间对NNNS评分的影响，同时考虑有无协变量。
到1月龄时，两组的运动质量均更高（P = 0.029）、嗜睡情况更少（P = 0.001）、不对称反射更少（P = 0.012），暴露组与对照组在NNNS评分上无显著差异。在出生后的第一个月内，暴露组婴儿的觉醒增加，而对照组婴儿的觉醒减少（P = 0.031），暴露组婴儿的总应激降低，对照组婴儿无变化（P = 0.026）。
与新生儿期相比，到1月龄时，暴露于MA的新生儿的总应激和觉醒情况有所改善。
