Document Detail

Prenatal drug exposure: infant and toddler outcomes.
MedLine Citation:
PMID:  20407980     Owner:  NLM     Status:  MEDLINE    
This manuscript provides an overview of the current scientific literature on the impact of maternal drug use, specifically opioids and cocaine, during pregnancy on the acute and long-term outcomes of infants and toddlers from birth through age 3 years. Emphasis with regard to opioids is placed on heroin and opioid substitutes used to treat opioid addiction, including methadone, which has long been regarded as the standard of care in pregnancy, and buprenorphine, which is increasingly being investigated and prescribed as an alternative to methadone. Controlled studies comparing methadone at high and low doses, as well as those comparing methadone with buprenorphine, are highlighted and the diagnosis and management of neonatal abstinence syndrome is discussed. Over the past two decades, attention of the scientific and lay communities has also been focused on the potential adverse effects of cocaine and crack cocaine, especially during the height of the cocaine epidemic in the United States. Herein, the findings are summarized from prospective studies comparing cocaine-exposed with non-cocaine-exposed infants and toddlers with respect to anthropometric growth, infant neurobehavior, visual and auditory function, and cognitive, motor, and language development. The potentially stigmatizing label of the so-called "crack baby" preceded the evidence now accumulating from well-designed prospective investigations that have revealed less severe sequelae in the majority of prenatally exposed infants than originally anticipated. In contrast to opioids, which may produce neonatal abstinence syndrome and infant neurobehavioral deficits, prenatal cocaine exposure appears to be associated with what has been described as statistically significant but subtle decrements in neurobehavioral, cognitive, and language function, especially when viewed in the context of other exposures and the caregiving environment which may mediate or moderate the effects. Whether these early findings may herald more significant learning and behavioral problems during school-age and adolescence when the child is inevitably confronted with increasing social and academic challenges is the subject of ongoing longitudinal research.
Emmalee S Bandstra; Connie E Morrow; Elana Mansoor; Veronica H Accornero
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Journal of addictive diseases     Volume:  29     ISSN:  1545-0848     ISO Abbreviation:  J Addict Dis     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-21     Completed Date:  2010-07-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9107051     Medline TA:  J Addict Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  245-58     Citation Subset:  IM    
University of Miami Miller School of Medicine, Department of Pediatrics, Division of Neonatal Medicine, Miami, FL 33101, USA.
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MeSH Terms
Buprenorphine / adverse effects
Child Development / drug effects*
Child, Preschool
Cocaine / adverse effects
Cocaine-Related Disorders / complications,  drug therapy
Heroin / adverse effects
Infant, Newborn
Methadone / adverse effects
Neonatal Abstinence Syndrome
Prenatal Exposure Delayed Effects*
Substance-Related Disorders / complications*,  drug therapy
Grant Support
K01 DA 16720/DA/NIDA NIH HHS; P50 DA 025484/DA/NIDA NIH HHS; R01 DA 006556/DA/NIDA NIH HHS
Reg. No./Substance:
50-36-2/Cocaine; 52485-79-7/Buprenorphine; 561-27-3/Heroin; 76-99-3/Methadone

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