Angelilli M L, Fischer H, Delaney-Black V, Rubinstein M, Ager J W, Sokol R J
Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan.
Clin Pediatr (Phila). 1994 Sep;33(9):514-6. doi: 10.1177/000992289403300901.
To determine whether children with language delays are more likely to have been exposed to cocaine in utero than children with normal language development, a case-control study was undertaken. Based on routine office screening in our primary-care clinic over a 1-year period, we identified 29 consecutive children, aged 24 to 48 months, as language-delayed. They were compared with an approximate 2:1 match of children without language delay who had been seen in the clinic on the same days and who were of similar age. There was more reported cocaine use during pregnancy (six of 29, 21%) among the language-delayed children than among the controls (five of 71, 7%). This difference is statistically significant (P < 0.05, chi 2 = 3.92; odds ratio = 3.4 +/- 2.2). Discriminant analysis revealed that both cocaine and nicotine exposure were associated with delayed language development--with an unexpected negative, i.e., an antagonistic, protective, interactive effect (F[3,96] = 4.66, R2 = 12.7%, P < .005); neither gender nor caretaker contributed to language development in this sample. These results suggest that children with language delay detected in a clinical setting are more likely to have been exposed in utero to cocaine than children with normal language development. Prenatal cocaine exposure should be a risk factor in monitoring development in children.
为了确定语言发育迟缓儿童相比于语言发育正常儿童在子宫内接触可卡因的可能性是否更高，我们开展了一项病例对照研究。基于我们初级保健诊所为期1年的常规门诊筛查，我们确定了连续29名年龄在24至48个月的语言发育迟缓儿童。将他们与同一天在诊所就诊且年龄相仿、未出现语言发育迟缓的儿童进行了约2:1的匹配。语言发育迟缓儿童中报告孕期使用可卡因的情况（29例中有6例，21%）多于对照组（71例中有5例，7%）。这种差异具有统计学意义（P < 0.05，卡方 = 3.92；比值比 = 3.4 ± 2.2）。判别分析显示，可卡因和尼古丁暴露均与语言发育迟缓有关——呈现出意外的负向，即拮抗、保护、交互作用（F[3,96] = 4.66，R2 = 12.7%，P <.005）；在该样本中，性别和照料者均未对语言发育产生影响。这些结果表明，在临床环境中检测出语言发育迟缓的儿童相比于语言发育正常的儿童，在子宫内接触可卡因的可能性更高。产前可卡因暴露应作为监测儿童发育的一个风险因素。
