Napiorkowski B, Lester B M, Freier M C, Brunner S, Dietz L, Nadra A, Oh W
Brown University School of Medicine, Department of Pediatrics, Women and Infants Hospital, Providence, Rhode Island 02905, USA.
Pediatrics. 1996 Jul;98(1):71-5.
This study had two objectives: (1) to assess infant behavior by using the NICU Network Neurobehavioral Scale (NNNS), an assessment designed specifically for prenatally drug-exposed infants; and (2) to control for the effects of polydrug use involving alcohol, marijuana, and cigarettes on the neurobehavioral status of the newborn infant.
The subjects and controls in this study were full-term infants of appropriate gestational age with no medical problems. At 1 to 2 days of age, 20 infants exposed to cocaine, alcohol, marijuana, and cigarettes; 17 infants exposed to alcohol and/or marijuana and cigarettes; and 20 drug-free infants were evaluated by using the Neonatal Intensive Care Unit Network Neurobehavioral Scale. The data were reduced to reflect clinically defined categories of neurobehavioral function and were analyzed by using analysis of variance and chi 2 statistics.
Cocaine-exposed infants showed increased tone and motor activity, more jerky movements, startles, tremors, back arching, and signs of central nervous system and visual stress than unexposed infants. They also showed poorer visual and auditory following. There were no differences in how the examination was administered to cocaine-exposed and nonexposed infants. Reduced birth weight and length were also observed in cocaine-exposed infants.
Differences attributable to cocaine-exposed infants were related to muscle tone and motor performance, following during orientation, and signs of stress. However, cocaine-exposed infants were not more difficult to test, nor did they require an alteration in the examination. Both neurobehavioral patterns of excitability and lethargy were observed. Findings may have been due to the synergistic effects of cocaine with alcohol and marijuana.
本研究有两个目的：（1）使用新生儿重症监护病房网络神经行为量表（NNNS）评估婴儿行为，该量表是专门为产前接触药物的婴儿设计的评估工具；（2）控制涉及酒精、大麻和香烟的多药使用对新生儿神经行为状态的影响。
本研究中的受试者和对照组为足月且胎龄合适、无医学问题的婴儿。在出生1至2天时，对20名接触可卡因、酒精、大麻和香烟的婴儿、17名接触酒精和/或大麻及香烟的婴儿以及20名未接触药物的婴儿使用新生儿重症监护病房网络神经行为量表进行评估。数据经整理以反映临床定义的神经行为功能类别，并使用方差分析和卡方统计进行分析。
与未接触可卡因的婴儿相比，接触可卡因的婴儿表现出肌张力和运动活动增加、更多的急促动作、惊跳、震颤、背部拱起以及中枢神经系统和视觉应激迹象。他们的视觉和听觉追踪能力也较差。对接触可卡因和未接触可卡因的婴儿进行检查的方式没有差异。在接触可卡因的婴儿中还观察到出生体重和身长降低。
接触可卡因的婴儿出现的差异与肌张力和运动表现、定向过程中的追踪能力以及应激迹象有关。然而，接触可卡因的婴儿并不更难测试，也不需要改变检查方式。观察到了兴奋和嗜睡两种神经行为模式。研究结果可能是由于可卡因与酒精和大麻的协同作用所致。
