Mehta S K, Finkelhor R S, Anderson R L, Harcar-Sevcik R A, Wasser T E, Bahler R C
MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
J Pediatr. 1993 Jun;122(6):945-9. doi: 10.1016/s0022-3476(09)90025-7.
This prospective study examined whether neonates of pregnant women who used cocaine during pregnancy are at a risk for the development of transient myocardial ischemia and altered autonomic function, as in adults. We studied 21 of 35 infants with a history of prenatal exposure to cocaine. The ST segment changes and heart rate variability were evaluated from three-channel Holter monitors within 48 hours of birth. The data were compared with those on 20 control infants with similar birth weight, gestational age, and postnatal age. Six infants (29%) who were exposed to cocaine in utero had transient ST segment elevation, versus only one infant (5%) from the control group (odds ratio = 7.6; 95% confidence interval, 1.14, 50.64). Heart rates, results of total power and low-frequency power spectral analyses for heart rate variability, and arrhythmias were not significantly different in the two groups. However, a lower ratio of low-to high-frequency power reflected increased vagal activity in cocaine-exposed infants. We conclude that cocaine use in pregnant mothers is associated with transient ST segment abnormalities in their infants. These abnormalities are consistent with transient myocardial ischemia.
这项前瞻性研究调查了孕期使用可卡因的孕妇所生的新生儿是否像成年人一样，有发生短暂性心肌缺血和自主神经功能改变的风险。我们研究了35名有产前可卡因暴露史的婴儿中的21名。在出生后48小时内，通过三通道动态心电图监测仪评估ST段变化和心率变异性。将这些数据与20名出生体重、胎龄和出生后年龄相似的对照婴儿的数据进行比较。6名（29%）子宫内暴露于可卡因的婴儿出现短暂性ST段抬高，而对照组中只有1名婴儿（5%）出现这种情况（比值比=7.6；95%置信区间，1.14，50.64）。两组的心率、心率变异性的总功率和低频功率谱分析结果以及心律失常情况无显著差异。然而，低频与高频功率的比值较低反映出暴露于可卡因的婴儿迷走神经活动增加。我们得出结论，孕期母亲使用可卡因与婴儿的短暂性ST段异常有关。这些异常与短暂性心肌缺血一致。
