O'Connor Angela, Seeber Carly, Harris Emma, Hamilton Dale, Sachmann Mark, Fisher Colleen
Women and Newborn Drug and Alcohol Service, King Edward Memorial Hospital, Perth, Western Australia, Australia.
Australian College of Midwifery, Canberra, Australian Capital Territory, Australia.
J Paediatr Child Health. 2020 Mar;56(3):372-378. doi: 10.1111/jpc.14618. Epub 2019 Sep 3.
To describe neurodevelopmental outcomes among a cohort of Western Australian infants exposed to maternal methamphetamine use during pregnancy and to determine whether the Ages and Stages Questionnaire is a reliable screening tool for this population.
Methamphetamine-using women were approached for participation when referred to the state-wide perinatal specialist drug and alcohol service for pregnancy care. Drug use during pregnancy was self-reported in each trimester using a standardised questionnaire. Ages and Stages Questionnaires were completed by infant care givers at 4 and 12 months, and development was formally assessed at 12 months using the Griffiths Mental Development Scales. Griffiths results for term-born infants in our cohort were compared to a Western Australian historical cohort of 443 healthy 1-2-year-olds.
A total of 112 methamphetamine-using pregnant women participated in the study, who gave birth to 110 live-born infants. Ages and Stages Questionnaires were completed for 89 (81%) and 78 (71%) of the infants at 4 and 12 months, respectively. The Ages and Stages assessment identified 30 infants (33.7%) as having a potential developmental delay at 4 months and 29 infants (38.7%) as having a potential developmental delay at 12 months. Griffiths assessments were performed on 64 (58%) of the infants, with a mean general quotient of 92.7. This was significantly lower in term-born babies compared to the historical cohort (who had a median general quotient of 113.0). There was a weak correlation between 12-month Ages and Stages scores and Griffiths general quotients (r = 0.322) and no correlation between 4-month Ages and Stages Questionnaire scores and later Griffiths results.
Infants born to women reporting methamphetamine use during pregnancy are at increased risk of developmental delay and may warrant enhanced developmental follow-up. However, they are a challenging group to follow due to complex psychosocial factors. Ages and Stages Questionnaires at 4 and 12 months were not helpful in screening for infants who had a developmental delay at 12 months.
描述西澳大利亚州一组孕期母亲使用甲基苯丙胺的婴儿的神经发育结局，并确定《年龄与阶段问卷》是否是该人群可靠的筛查工具。
当使用甲基苯丙胺的孕妇被转介到全州围产期专科药物和酒精服务机构进行孕期护理时，邀请她们参与研究。在每个孕期使用标准化问卷自我报告孕期药物使用情况。婴儿护理人员在婴儿4个月和12个月时完成《年龄与阶段问卷》，并在12个月时使用格里菲斯心理发展量表对发育情况进行正式评估。将我们队列中足月出生婴儿的格里菲斯评估结果与西澳大利亚州一个由443名健康1至2岁儿童组成的历史队列进行比较。
共有112名使用甲基苯丙胺的孕妇参与了研究，她们生下了110名活产婴儿。分别有89名（81%）和78名（71%）婴儿在4个月和12个月时完成了《年龄与阶段问卷》。《年龄与阶段评估》确定30名婴儿（33.7%）在4个月时存在潜在发育迟缓，29名婴儿（38.7%）在12个月时存在潜在发育迟缓。对64名（58%）婴儿进行了格里菲斯评估，平均综合商数为92.7。与历史队列（中位数综合商数为113.0）相比，足月出生婴儿的这一数值显著更低。12个月时的《年龄与阶段问卷》得分与格里菲斯综合商数之间存在弱相关性（r = 0.322），4个月时的《年龄与阶段问卷》得分与后期的格里菲斯结果之间无相关性。
孕期报告使用甲基苯丙胺的女性所生婴儿发育迟缓风险增加，可能需要加强发育随访。然而，由于复杂的社会心理因素，对他们进行随访具有挑战性。4个月和12个月时的《年龄与阶段问卷》无助于筛查出12个月时存在发育迟缓的婴儿。
