home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
The Arsenal Files 6
/
The Arsenal Files 6 (Arsenal Computer).ISO
/
health
/
med9603.zip
/
M9630636.TXT
< prev
next >
Wrap
Text File
|
1996-02-27
|
4KB
|
56 lines
Document 0636
DOCN M9630636
TI Neurological correlates of fetal cocaine exposure: transient hypertonia
of infancy and early childhood.
DT 9603
AU Chiriboga CA; Vibbert M; Malouf R; Suarez MS; Abrams EJ; Heagarty MC;
Brust JC; Hauser WA; Department of Neurology, College of Physicians and
Surgeons,; Columbia University, New York, New York 10032, USA.
SO Pediatrics. 1995 Dec;96(6):1070-7. Unique Identifier : AIDSLINE
MED/96095156
AB OBJECTIVE. To assess whether prenatal cocaine exposure has any long-term
effects on neurodevelopment. DESIGN. A prospective cohort study with
examiners blind to drug exposure and human immunodeficiency virus (HIV)
status. SUBJECTS. Of 144 high-risk infants enrolled in a perinatal HIV
neurodevelopmental study, 119 (83%) infants with both neurological and
urine toxicology measures were followed up to age 24 months. METHODS.
Neurological and developmental assessments were analyzed at 6-month
intervals grouped according to the presence of cocaine in urine
toxicology: 51 infants were cocaine-positive. Adjusted odds ratios (ORs)
and 95% confidence interval (CI) were obtained by logistic regression
equations that adjusted for perinatal variables, including measures of
fetal growth, gestation, HIV status, and infant toxicology results.
SETTING. Harlem Hospital Center from 1988 to 1992. RESULTS. At age 6
months, 21 of 51 (41%) cocaine-positive children exhibited hypertonia of
any type (hypertonic tetraparesis, hypertonic diparesis, and hypertonic
hemiparesis) compared with 17 of 68 (25%) cocaine-negative infants (OR =
2.1, CI = 1.0-4.6). Cocaine-positive infants were four times more likely
to show hypertonic tetraparesis (HTP) than cocaine-negative infants (OR
= 4.0; CI = 1.5-10.8). The association remained significant in
multivariate analyses. Hypertonia, consistent with cerebral palsy,
diminished over time in both groups. In 97% of affected infants
hypertonia resolved by 24 months. Arm hypertonia abated first; leg
hypertonia remained in some children up to age 18 months. No differences
in development scores between cocaine-positive and cocaine-negative were
noted at any age interval. However, among cocaine-positive infants those
with early HTP showed significantly lower mean developmental scores at 6
and 12 month compared to infants without HTP. CONCLUSION. Cocaine
positivity urine toxicology at birth is associated with hypertonia
during infancy. Such cocaine-induced effects are usually symmetrical,
transient, and the majority of exposed children outgrow hypertonia by 24
months of life. Among cocaine-positive infants, HTP may be a marker for
later developmental impairments.
DE Adult Chi-Square Distribution *Cocaine/URINE Cohort Studies
Comparative Study Female Human HIV Seronegativity HIV
Seropositivity/EPIDEMIOLOGY HIV-1/IMMUNOLOGY Infant Infant, Newborn
Infant, Small for Gestational Age Male Muscle Hypertonia/*CHEMICALLY
INDUCED/EPIDEMIOLOGY/URINE Nervous System Diseases/*CHEMICALLY
INDUCED/EPIDEMIOLOGY/URINE New York City/EPIDEMIOLOGY Odds Ratio
Pregnancy *Prenatal Exposure Delayed Effects Prospective Studies
Substance Dependence/*COMPLICATIONS Support, U.S. Gov't, P.H.S.
JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).