Fetters L, Tronick E Z
Boston University, Department of Physical Therapy, Massachusetts 02215, USA.
Pediatrics. 1996 Nov;98(5):938-43.
The objective of this study is to describe the longitudinal course of motor development of a group of infants exposed to cocaine in utero and an unexposed control group.
Subjects included 28 in utero-exposed infants and 22 unexposed infants matched for race, income of the family, and mother's educational level. Infants were evaluated at 1 month with the Alberta Infant Motor Scale (AIMS), at 4 months with the AIMS and Movement Assessment of Infants (MAI), at 7 months with the AIMS and MAI, and at 15 months with the Peabody Developmental Motor Scales (PDMS).
At 4 months, compared with the unexposed infants, a significantly larger proportion of the exposed infants fell below the 50th percentile on the AIMS and had greater proportion of suspicious risk scores on the MAI. At 7 months infants in the exposed group had lower AIMS and MAI scores than the control group. There was no difference between groups on the motor scales at 1, 4, or 15 months. At all ages more infants in both groups scored significantly less than the expected norms on all scales. Performance was unrelated to a cumulative risk index made up of demographic, medical, and social factors. Almost all subjects had risk scores that placed them at extremely high levels of risk. Performance may have been related to a difference in weight between groups at 7 months and to decreasing weights for both groups by 15 months.
In utero cocaine exposure has a significant, although relatively small, effect on infant motor performance late in infancy. However, regardless of exposure status, these infants had poor performance that may be accounted for by a heavy accumulation of risk factors associated with poverty.
本研究的目的是描述一组子宫内接触可卡因的婴儿和未接触可卡因的对照组婴儿运动发育的纵向过程。
研究对象包括28名子宫内接触可卡因的婴儿和22名未接触可卡因的婴儿，两组婴儿在种族、家庭收入和母亲教育水平方面相匹配。婴儿在1个月时使用艾伯塔婴儿运动量表（AIMS）进行评估，在4个月时使用AIMS和婴儿运动评估量表（MAI）进行评估，在7个月时使用AIMS和MAI进行评估，在15个月时使用皮博迪发育运动量表（PDMS）进行评估。
在4个月时，与未接触可卡因的婴儿相比，接触可卡因的婴儿中，在AIMS量表上低于第50百分位数的比例显著更高，在MAI量表上有可疑风险评分的比例也更高。在7个月时，接触可卡因组的婴儿AIMS和MAI得分低于对照组。在1个月、4个月或15个月时，两组在运动量表上没有差异。在所有年龄段，两组中更多的婴儿在所有量表上的得分均显著低于预期标准。表现与由人口统计学、医学和社会因素组成的累积风险指数无关。几乎所有受试者的风险评分都处于极高风险水平。表现可能与7个月时两组之间的体重差异以及到15个月时两组体重的下降有关。
子宫内接触可卡因对婴儿期晚期的婴儿运动表现有显著影响，尽管影响相对较小。然而，无论接触状况如何，这些婴儿的表现都很差，这可能是由与贫困相关的大量风险因素积累所致。
