Maternal drug use during pregnancy: Are preterm and full-term infants affected differently?

Brown, Josephine V.; Bakeman, Roger; Coles, Claire D.; Sexson, William R.; Demi, Alice

doi:10.1037/0012-1649.34.3.540

Cited by 83 publications

(78 citation statements)

References 58 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…32 We found that decreasing or low tobacco use was the only pattern associated with greater birth weight, length, and head circumference, compared with decreasing patterns of use of other drugs. The clinical implications of this study are that illicit drug use as well as alcohol and tobacco use should be curtailed during pregnancy.…”

Section: Discussionmentioning

confidence: 87%

Association Between Patterns of Maternal Substance Use and Infant Birth Weight, Length, and Head Circumference

et al. 2004

View full text Add to dashboard Cite

ABSTRACT. Objective. To determine the effects of patterns of drug use during term pregnancy on infant growth parameters at birth.Methods. Histories of cocaine, opiate, alcohol, tobacco, and marijuana use during the 3-month period before pregnancy and the 3 trimesters of pregnancy were recorded at the infants' 1-month visit. Patterns of use were categorized as consistently high, moderate, or low/ none or increasing/decreasing, and effects on growth parameters were analyzed in multivariate linear regression analyses, with adjustment for clinical site, maternal age, prepregnancy weight, multidrug use, and socioeconomic status.Results. A total of 241 cocaine-exposed women and 410 non-cocaine-exposed women participated in the study. In the cocaine-exposed group, 75% used alcohol, 90% used tobacco, and 53% used marijuana; in the noncocaine-exposed group, 57% used alcohol, 34% used tobacco, and 19% used marijuana. Birth weight, birth length, and head circumference were significantly greater among infants born to women who used no drugs, compared with women with any cocaine, opiate, alcohol, tobacco, or marijuana use, and were greater among infants born to cocaine nonusers, compared with cocaine users. With adjustment for confounders, birth weight was significantly affected by cocaine (deficit of 250 g with consistently low pattern) and tobacco (deficits of 232 g with consistently high pattern, 173 g with consistently moderate pattern, 153 g with decreasing pattern, and 103 g with consistently low pattern). Head size was affected by cocaine (deficit of 0.98 cm with consistently moderate pattern) and tobacco (deficits of 0.72 cm with consistently high pattern and 0.89 cm with consistently moderate pattern). Birth length was affected by tobacco use only (deficits of 0.82 cm with consistently high pattern and 0.98 cm with decreasing use).Conclusion. Patterns of tobacco use during pregnancy affect birth weight, length, and head circumference, whereas cocaine affects birth weight and head size, when adjustments are made for confounders, including multidrug use. Pediatrics 2004;114:e226 -e234. URL: http: //www.pediatrics.org/cgi/content/full/114/2/e226; prenatal, cocaine, alcohol, tobacco, marijuana, infant birth weight, length, head circumference.ABBREVIATIONS. MISU, Maternal Inventory of Substance Use. M aternal cocaine use during pregnancy has been associated with decreased growth parameters at birth for infants. [1][2][3][4][5] Women who use cocaine during pregnancy are often exposed to many drugs, including alcohol and tobacco, 1-6 both of which have been shown to have effects on birth weight in studies evaluating the use of these substances alone or in combination. [7][8][9][10][11][12][13] The timing and amount of fetal exposure to cocaine, tobacco, and alcohol during pregnancy also have been noted to influence birth weight. 2,10,11,14 Infants born to women who stopped smoking had higher birth weights than did those born to women who reduced smoking or who did not change behavior. 10,11 Infants born to women who drank ...

show abstract

Section: Discussionmentioning

confidence: 87%

Association Between Patterns of Maternal Substance Use and Infant Birth Weight, Length, and Head Circumference

et al. 2004

View full text Add to dashboard Cite

show abstract

“…10,12 Brown et al 11 reported greater levels of irritability in preterm infants exposed to cocaine in utero. In our large cohort, we observed no relationship between the gestation and the development of NAS.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9] Preterm infants may be less likely than term infants to exhibit signs of NAS resulting from opiate or opioid exposure. [10][11][12] There is conflicting evidence with regard to optimal maternal methadone dose in pregnancy, with some studies showing an association between maternal methadone dose and the risk of NAS and some studies showing no such relationship. 9,[13][14][15][16][17][18][19] Duration of stay may be longer for infants born to polydrug-misusing mothers, 20 and since higher doses of methadone have been associated with less polydrug use, reducing methadone during pregnancy may not be justified.…”

Section: Introductionmentioning

confidence: 99%

Maternal methadone use in pregnancy: factors associated with the development of neonatal abstinence syndrome and implications for healthcare resources

Dryden

Young

Hepburn

et al. 2009

BJOG

214

205

View full text Add to dashboard Cite

Objectives The objectives of this study were to investigate factors associated with the development of neonatal abstinence syndrome (NAS) and to assess the implications for healthcare resources of infants born to drug-misusing women.Design Retrospective cohort study from 1 January 2004 to 31 December 2006.Setting Inner-city maternity hospital providing dedicated multidisciplinary care to drug-misusing women.Population Four hundred and fifty singleton pregnancies of drugmisusing women prescribed substitute methadone in pregnancy.Methods Case note review.Main outcome measures Development of NAS and duration of infant hospital stay.Results 45.5% of infants developed NAS requiring pharmacological treatment. The odds ratio of the infant developing NAS was independently related to prescribed maternal methadone dose rather than associated polydrug misuse. Breastfeeding was associated with reduced odds of requiring treatment for NAS (OR 0.55, 95% CI 0.34-0.88). Preterm birth did not influence the odds of the infant receiving treatment for NAS. 48.4% infants were admitted to the neonatal unit (NNU) 40% of these primarily for treatment of NAS. The median total hospital stay for all infants was 10 days (interquartile range 7-17 days). Infants born to methadone-prescribed drug-misusing mothers represented 2.9% of hospital births, but used 18.2% of NNU cot days.Conclusions Higher maternal methadone dose is associated with a higher incidence of NAS. Pregnant drug-misusing women should be encouraged and supported to breastfeed. Their infants are extremely vulnerable and draw heavily on healthcare resources.Keywords Breastfeeding, health resources, methadone, neonatal abstinence syndrome.

show abstract

“…Thus, one pathway explaining potential associations between cocaine exposure and infant reactivity and regulation may be via compromised fetal growth. Fetal growth may also moderate this association (Brown et al, 1998a). In other words, fetal growth may interact with exposure status such that cocaine-exposed infants with poor fetal growth such as lower birthweight (controlling for gestational age) may be at highest risk for poor autonomic regulation.…”

Section: Indirect Effects and Moderationmentioning

confidence: 99%

Prenatal cocaine and other substance exposure: Effects on infant autonomic regulation at 7 months of age

Schuetze

Eiden

Coles

2007

Developmental Psychobiology

Self Cite

View full text Add to dashboard Cite

This study examined the association between prenatal exposure to cocaine and autonomic regulation at 7 months of age. Heart rate (HR) and respiratory sinus arrhythmia (RSA) were obtained from 154 (79 exposed, and 75 nonexposed) infants during baseline and tasks designed to elicit positive and negative affect. Cocaine-exposed infants had higher HR during the positive affect task. There was a significant suppression of RSA during the negative affect task for nonexposed infants but not for exposed infants. Fetal growth and maternal caregiving behavior did not mediate or moderate this association. These results provide additional support for an association between prenatal cocaine exposure and dysregulation during infancy.

show abstract

Maternal drug use during pregnancy: Are preterm and full-term infants affected differently?

Cited by 83 publications

References 58 publications

Association Between Patterns of Maternal Substance Use and Infant Birth Weight, Length, and Head Circumference

Association Between Patterns of Maternal Substance Use and Infant Birth Weight, Length, and Head Circumference

Maternal methadone use in pregnancy: factors associated with the development of neonatal abstinence syndrome and implications for healthcare resources

Prenatal cocaine and other substance exposure: Effects on infant autonomic regulation at 7 months of age

Contact Info

Product

Resources

About