Brain ultrasonography findings in neonates with exposure to cocaine during pregnancy

Abstract

Background Cocaine exposure during pregnancy has been reported to have detrimental effects on the fetus. Objective To describe the findings on cranial ultrasonography (CUS) as part of a neonatal screening programme for exposed neonates. Materials and methods The study was a semiprospective analysis of a 12-year cohort of neonates born to mothers who had used cocaine during their pregnancy and who had follow-up according to a strict clinical protocol. Results In total, 154 neonates (78 boys, 76 girls) were included, of whom 29 (19%) were born preterm, and 125 (81%) were born full-term. Abnormalities on CUS were seen in 37 neonates (24%; 95% CI 18-31%). The abnormalities were classified as minor in 20 (13%; 95% CI 9-19%) and mildly abnormal in 17 (11%; 95% CI 7-17%). None of the infants showed severe abnormalities. The abnormalities were not associated with the duration or maximum amount of cocaine use during pregnancy. Conclusion None of the infants had severe abnormalities. Detected abnormalities were not correlated with the duration or maximum amount of cocaine use. Given these findings, we feel that routine cranial ultrasonography in this population is not warranted.

Ultrasound Evaluation of Brain Parenchyma in Preterm Infants with Prenatal Opioid Exposure

“…Antenatal exposure to opioids is reported to adversely affect fetal brain development, primarily the developing oligodendrocyte and the processes of myelination (white matter microstructure), connectivity between parts of the brain, and the size of multiple brain regions, including the basal ganglia, thalamus, and cerebellar white matter 3 . This is clinically observed as smaller head circumferences at birth in opioid-exposed infants, regardless of type of maternal opioid exposure 4,5 . Additionally, there is concern for an association between prenatal opioid exposure and alterations in neurocognitive development and risk for ophthalmic diagnoses [6][7][8] .…”