Datta-Bhutada S, Johnson H L, Rosen T S
Department of Pediatrics, Babies and Childrens Hospital, Columbia University, New York, N.Y., USA.
J Perinatol. 1998 May-Jun;18(3):183-8.
Adverse health effects are associated with intrauterine cocaine exposure. The purpose of this study was to investigate the impact of fetal cocaine and crack exposure on neonatal outcome.
We enrolled 386 mother-infant pairs, including 130 matched control pairs, in the study. The course of pregnancy and delivery was followed and neonatal outcome was assessed by physical and neurologic examination, as well as by the Brazelton Neonatal Behavioral Assessment Scale and the Neonatal Stress Scale.
The cocaine-exposed neonates had significantly more adverse effects than the matched control infants. Birth weight, length, and head circumference were significantly lower in the cocaine- and crack-exposed infants (p < or = 0.001). There were significantly more premature infants (p < or = 0.007) in this group. They demonstrated significant abnormalities on the neurologic examination (p < or = 0.001), inferior performance on the Brazelton Neonatal Behavioral Assessment Scale (p < or = 0.001), and higher scores on the Neonatal Stress Scale (p < or = 0.001). Predictors of negative neonatal outcome were maternal age (p < or = 0.02), poor paternal relationship with the mother (p < or = 0.002), crack use (p < or = 0.004), cocaine use (p < or = 0.009), and marijuana use (p < or = 0.05).
The single most important predictor of neonatal outcome is the frequency, quantity, and type of cocaine used.
不良健康影响与宫内可卡因暴露有关。本研究的目的是调查胎儿可卡因和快克暴露对新生儿结局的影响。
我们招募了386对母婴，其中包括130对匹配的对照母婴参与研究。对妊娠和分娩过程进行跟踪，并通过体格检查、神经学检查以及布雷泽尔顿新生儿行为评估量表和新生儿应激量表对新生儿结局进行评估。
暴露于可卡因的新生儿比匹配的对照婴儿有更多显著的不良影响。暴露于可卡因和快克的婴儿出生体重、身长和头围显著更低（p≤0.001）。该组早产儿显著更多（p≤0.007）。他们在神经学检查中表现出显著异常（p≤0.001），在布雷泽尔顿新生儿行为评估量表上表现较差（p≤0.001），在新生儿应激量表上得分更高（p≤0.001）。新生儿不良结局的预测因素包括母亲年龄（p≤0.02）、父亲与母亲关系不佳（p≤0.002）、使用快克（p≤0.004）、使用可卡因（p≤0.009）和使用大麻（p≤0.05）。
新生儿结局的最重要单一预测因素是使用可卡因的频率、数量和类型。
