Chiriboga C A
Department of Neurology, Columbia University College of Physicians and Surgeons, New York, New York.
Neurol Clin. 1993 Aug;11(3):707-28.
The adverse effects of fetal drug exposures are well documented. Evidence for FAS, impaired intrauterine growth, birth defects, and mental retardation related to alcohol is compelling; evidence for alcohol-induced adverse behaviors and impaired speech is tenuous. Teratogenic, cognitive, or behavioral effects associated with prenatal exposure to marijuana, cigarettes, cocaine, or opiates have not been well established. The most convincing finding related to prenatal exposure to such substances is IUGR. Impaired fetal growth, especially of brain, may indirectly mediate drug effects on cognition. The abnormal neonatal neuro-behaviors described herein have no apparent impact on subsequent development. The development of opiate-exposed children, particularly those with withdrawal symptoms, however, appears to be more vulnerable to the adverse effects of an impoverished environment.
胎儿药物暴露的不良影响已有充分记录。与酒精相关的胎儿酒精谱系障碍、宫内生长受限、出生缺陷和智力迟钝的证据确凿;与酒精引起的不良行为和言语障碍相关的证据则较为薄弱。产前接触大麻、香烟、可卡因或阿片类药物所产生的致畸、认知或行为影响尚未明确。与产前接触这些物质相关的最有说服力的发现是宫内生长受限。胎儿生长受限,尤其是脑部生长受限,可能间接介导药物对认知的影响。本文所述的异常新生儿神经行为对后续发育没有明显影响。然而,接触阿片类药物的儿童,尤其是有戒断症状的儿童,其发育似乎更容易受到贫困环境的不利影响。