Nair P, Rothblum S, Hebel R
Department of Pediatrics, University of Maryland School of Medicine, Baltimore 21201.
Clin Pediatr (Phila). 1994 May;33(5):280-5. doi: 10.1177/000992289403300505.
This study evaluated the neonatal outcome of infants with evidence of fetal exposure to cocaine, opiates, and cannabinoids. Subjects were from the newborn nursery of an inner-city university teaching hospital. Meconium from 141 infants admitted to the full-term nursery was analyzed for metabolites of opiates, cocaine, and cannabinoids. The population was 72% African-American; 82% had medical assistance; history of drug use was reported in the medical records in 18%; mean maternal age was 24.2 years; mean birth weight was 3,234 +/- 502 g; and neonatal abstinence syndrome was reported in 7%. Meconium analysis data showed the following: 52.5% were drug-free; cocaine was present in 31%, opiates in 18% (cocaine and/or opiates 39%), and cannabinoids in 17%. In 38 infants in whom urine toxicology was obtained for clinical indications, meconium was more sensitive than urine in detecting drug exposure (55.3% vs 31.5%). There was no significant difference between cocaine/opiate-exposed and drug-free infants in race, socioeconomic status, maternal age, birth weight, head circumference, length, and Apgar scores. Cocaine/opiate-exposed infants had greater length of stay and increased frequency of maternal sexually transmitted diseases during pregnancy, with a trend toward a higher percent with fetal distress.
本研究评估了有胎儿接触可卡因、阿片类药物和大麻素证据的婴儿的新生儿结局。研究对象来自一家市中心大学教学医院的新生儿病房。对141名入住足月病房的婴儿的胎粪进行了阿片类药物、可卡因和大麻素代谢物分析。研究人群中72%为非裔美国人；82%有医疗救助；18%的病历中有药物使用史；产妇平均年龄为24.2岁；平均出生体重为3234±502克；7%的婴儿报告有新生儿戒断综合征。胎粪分析数据显示如下：52.5%未检测到药物；31%含有可卡因，18%含有阿片类药物（可卡因和/或阿片类药物占39%），17%含有大麻素。在38名因临床指征进行尿液毒理学检测的婴儿中，胎粪在检测药物接触方面比尿液更敏感（55.3%对31.5%）。在种族、社会经济地位、产妇年龄、出生体重、头围、身长和阿氏评分方面，接触可卡因/阿片类药物的婴儿与未接触药物的婴儿之间没有显著差异。接触可卡因/阿片类药物的婴儿住院时间更长，孕期产妇性传播疾病的发生率更高，胎儿窘迫的比例有升高趋势。
