Document Detail


Infant autonomic functioning and neonatal abstinence syndrome.
MedLine Citation:
PMID:  20189732     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Neonatal abstinence syndrome (NAS) expression is widely variable among affected infants and the reasons for this variability are largely unknown; mechanisms that predispose infants to NAS expression are not understood. It has been postulated that the regulatory problems of prenatally drug exposed infants are manifested in dysfunctional vagal regulation of autonomic processes. The current study examines whether cardiac vagal tone, an indicator of parasympathetic neuroregulation, provides a marker for autonomic dysregulation subsequently expressed as NAS in prenatally opioid-exposed newborns.
METHODS: Heart period (HP) and cardiac vagal tone (V) were derived from electrocardiogram data collected from 64 methadone-exposed infants on postnatal days 1 and 3. The postpartum NAS course was assessed serially.
RESULTS: Infants with lower V on day 1 had significantly higher NAS symptomatology on day 3. Boys had more severe NAS symptoms than girls through the first 4 days of life and, among infants receiving pharmacologic treatment for NAS, boys required longer treatment course and hospitalizations. Greater poly-drug exposure, detected through toxicology screening throughout pregnancy, and cocaine use in particular, were associated with lower V and shorter HP (faster heart rate) in newborns. Multiple regression models accounted for 25-35% of the variance in NAS symptoms and duration of hospitalization in methadone-exposed infants. Significant predictors included infant sex, SSRI/SNRI use, and cigarette smoking.
CONCLUSIONS: Results support the hypothesis of a biologic vulnerability of autonomic regulatory functioning in methadone-exposed infants and greater male infant vulnerability to maternal methadone use.
Authors:
Lauren M Jansson; Janet A Dipietro; Andrea Elko; Martha Velez
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-03-01
Journal Detail:
Title:  Drug and alcohol dependence     Volume:  109     ISSN:  1879-0046     ISO Abbreviation:  Drug Alcohol Depend     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-24     Completed Date:  2010-08-18     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  7513587     Medline TA:  Drug Alcohol Depend     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  198-204     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adult
Apgar Score
Autonomic Nervous System / physiopathology*
Cocaine-Related Disorders / complications
Data Interpretation, Statistical
Electrocardiography / drug effects
Female
Heart Rate / drug effects
Hospitalization
Humans
Infant
Infant, Newborn
Length of Stay
Male
Methadone / adverse effects
Narcotics / adverse effects
Neonatal Abstinence Syndrome / physiopathology*
Opioid-Related Disorders / physiopathology,  rehabilitation
Pregnancy
Serotonin Uptake Inhibitors / adverse effects
Sex Characteristics
Smoking / adverse effects
Substance Abuse Detection
Treatment Outcome
Vagus Nerve / physiopathology
Grant Support
ID/Acronym/Agency:
R01 DA019934/DA/NIDA NIH HHS; R01 DA019934/DA/NIDA NIH HHS; R01 DA019934-05/DA/NIDA NIH HHS
Chemical
Reg. No./Substance:
0/Narcotics; 0/Serotonin Uptake Inhibitors; UC6VBE7V1Z/Methadone
Comments/Corrections

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