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THE IMPACT OF PRENATAL DRUG EXPOSURE ON THE NEONATE
- Source :
- Obstetrics and Gynecology Clinics of North America. 25:169-194
- Publication Year :
- 1998
- Publisher :
- Elsevier BV, 1998.
-
Abstract
- Several social or recreational drugs singly or together have demonstrated effects on the fetus and neonate, with those effects extending into adulthood. The use of recreational drugs during pregnancy remains a major health problem, with adverse effects including higher rates of fetal distress and demise, lower Apgar scores, growth retardation, and adverse neurodevelopmental outcome. Ethanol has the most profound effects, with physical stigmata of the drug seen in one third of exposed infants. In children without the affected physical appearance, profound neurodevelopmental sequelae have been demonstrated. Other drugs, such as cocaine, heroin, amphetamines, and nicotine, have been associated with impaired fetal growth and acute withdrawal during the neonatal period. Subsequently, these infants and children have an increased risk for altered neurodevelopment and long-term health status. Long-term follow-up and assessment are essential. The risk of neonatal withdrawal or abstinence syndrome is greatest with narcotic drugs but has been found to occur in neonates following exposure to cocaine, nicotine, and amphetamines. Early treatment with tincture of opium, paregoric, or phenobarbital is crucial. Assessment of the overall health status of the infant should include growth parameters, signs and symptoms of infection (especially hepatitis, syphilis, and immunodeficiency viruses), and neurobehavioral function. Such assessments should not be limited to the newborn period, as neurodevelopmental sequelae may not be manifest until later in infancy and childhood. In addition, evaluation of the social milieu is warranted because of the increased risk for neglect and abuse of drug-exposed infants and children. Early intervention, maternal drug rehabilitation treatment, and parenting classes are frequently prescribed, but their efficacy is variable. Further investigations should study the potential benefits of these recommendations.
- Subjects :
- Drug
Pediatrics
medicine.medical_specialty
Neonatal withdrawal
Substance-Related Disorders
Developmental Disabilities
media_common.quotation_subject
Heroin
Neonatal Screening
Pregnancy
medicine
Fetal distress
Humans
Adverse effect
Maternal-Fetal Exchange
media_common
Paregoric
business.industry
Infant, Newborn
Obstetrics and Gynecology
medicine.disease
Abstinence Syndrome
Prenatal Exposure Delayed Effects
Female
business
Neonatal Abstinence Syndrome
medicine.drug
Subjects
Details
- ISSN :
- 08898545
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- Obstetrics and Gynecology Clinics of North America
- Accession number :
- edsair.doi.dedup.....e8ce490b34aba9c49a4fd8fa89cf828c
- Full Text :
- https://doi.org/10.1016/s0889-8545(05)70364-8