Acute neonatal effects of cocaine exposure during pregnancy

Charles R Bauer, John C. Langer, Seetha Shankaran, Henrietta S. Bada, Barry Lester, Linda L. Wright, Heidi Krause-Steinrauf, Vincent L. Smeriglio, Loretta P. Finnegan, Penelope L. Maza, Joel Verter

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

Objective: To identify associations between cocaine exposure during pregnancy and medical conditions in newborn infants from birth through hospital discharge. Design: Multisite, prospective, randomized study. Setting: Brown University, University of Miami, University of Tennessee (Memphis), and Wayne State University. Subjects: A total of 717 cocaine-exposed infants and 7442 nonexposed infants. Main Outcome Measures: Results of physical examination and conditions observed during hospitalization. Results: Cocaine-exposed infants were about 1.2 weeks younger, weighed 536 g less, measured 2.6 cm shorter, and had head circumference 1.5 cm smaller than nonexposed infants (all P<.001). Results did not confirm previously reported abnormalities. Central and autonomic nervous system symptoms were more frequent in the exposed group: jittery/tremors (adjusted odds ratio, 2.17; 99% confidence interval, 1.44-3.29), high-pitched cry (2.44; 1.06-5.66), irritability (1.81; 1.18-2.80), excessive suck (3.58; 1.63-7.88), hyperalertness (7.78; 1.72-35.06), and autonomic instability (2.64; 1.17-5.95). No differences were detected in organ systems by ultrasound examination. Exposed infants had more infections (3.09; 1.76-5.45), including hepatitis (13.46; 7.46-24.29), syphilis (8.84; 3.74-20.88), and human immunodeficiency virus exposure (12.37; 2.20-69.51); were less often breastfed (0.26; 0.15-0.44); had more child protective services referrals (48.92; 28.77-83.20); and were more often not living with their biological mother (18.70; 10.53-33.20). Conclusions: Central and autonomic nervous system symptoms were more frequent in the exposed cohort and persisted in an adjusted analysis. They were usually transient and may be a true cocaine effect. Abnormal anatomic outcomes previously reported were not confirmed. Increased infections, particularly sexually transmitted diseases, pose a serious public health challenge. Exposure increased involvement of child protective services and out-of-home placement.

Original languageEnglish
Pages (from-to)824-834
Number of pages11
JournalArchives of Pediatrics and Adolescent Medicine
Volume159
Issue number9
DOIs
StatePublished - Sep 1 2005

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Cocaine
Pregnancy
Autonomic Nervous System
Central Nervous System
Tremor
Syphilis
Sexually Transmitted Diseases
Infection
Hepatitis
Physical Examination
Hospitalization
Referral and Consultation
Public Health
Odds Ratio
Head
Mothers
Outcome Assessment (Health Care)
HIV
Parturition
Newborn Infant

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Bauer, C. R., Langer, J. C., Shankaran, S., Bada, H. S., Lester, B., Wright, L. L., ... Verter, J. (2005). Acute neonatal effects of cocaine exposure during pregnancy. Archives of Pediatrics and Adolescent Medicine, 159(9), 824-834. https://doi.org/10.1001/archpedi.159.9.824

Acute neonatal effects of cocaine exposure during pregnancy. / Bauer, Charles R; Langer, John C.; Shankaran, Seetha; Bada, Henrietta S.; Lester, Barry; Wright, Linda L.; Krause-Steinrauf, Heidi; Smeriglio, Vincent L.; Finnegan, Loretta P.; Maza, Penelope L.; Verter, Joel.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 159, No. 9, 01.09.2005, p. 824-834.

Research output: Contribution to journalArticle

Bauer, CR, Langer, JC, Shankaran, S, Bada, HS, Lester, B, Wright, LL, Krause-Steinrauf, H, Smeriglio, VL, Finnegan, LP, Maza, PL & Verter, J 2005, 'Acute neonatal effects of cocaine exposure during pregnancy', Archives of Pediatrics and Adolescent Medicine, vol. 159, no. 9, pp. 824-834. https://doi.org/10.1001/archpedi.159.9.824
Bauer CR, Langer JC, Shankaran S, Bada HS, Lester B, Wright LL et al. Acute neonatal effects of cocaine exposure during pregnancy. Archives of Pediatrics and Adolescent Medicine. 2005 Sep 1;159(9):824-834. https://doi.org/10.1001/archpedi.159.9.824
Bauer, Charles R ; Langer, John C. ; Shankaran, Seetha ; Bada, Henrietta S. ; Lester, Barry ; Wright, Linda L. ; Krause-Steinrauf, Heidi ; Smeriglio, Vincent L. ; Finnegan, Loretta P. ; Maza, Penelope L. ; Verter, Joel. / Acute neonatal effects of cocaine exposure during pregnancy. In: Archives of Pediatrics and Adolescent Medicine. 2005 ; Vol. 159, No. 9. pp. 824-834.
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AU - Krause-Steinrauf, Heidi

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N2 - Objective: To identify associations between cocaine exposure during pregnancy and medical conditions in newborn infants from birth through hospital discharge. Design: Multisite, prospective, randomized study. Setting: Brown University, University of Miami, University of Tennessee (Memphis), and Wayne State University. Subjects: A total of 717 cocaine-exposed infants and 7442 nonexposed infants. Main Outcome Measures: Results of physical examination and conditions observed during hospitalization. Results: Cocaine-exposed infants were about 1.2 weeks younger, weighed 536 g less, measured 2.6 cm shorter, and had head circumference 1.5 cm smaller than nonexposed infants (all P<.001). Results did not confirm previously reported abnormalities. Central and autonomic nervous system symptoms were more frequent in the exposed group: jittery/tremors (adjusted odds ratio, 2.17; 99% confidence interval, 1.44-3.29), high-pitched cry (2.44; 1.06-5.66), irritability (1.81; 1.18-2.80), excessive suck (3.58; 1.63-7.88), hyperalertness (7.78; 1.72-35.06), and autonomic instability (2.64; 1.17-5.95). No differences were detected in organ systems by ultrasound examination. Exposed infants had more infections (3.09; 1.76-5.45), including hepatitis (13.46; 7.46-24.29), syphilis (8.84; 3.74-20.88), and human immunodeficiency virus exposure (12.37; 2.20-69.51); were less often breastfed (0.26; 0.15-0.44); had more child protective services referrals (48.92; 28.77-83.20); and were more often not living with their biological mother (18.70; 10.53-33.20). Conclusions: Central and autonomic nervous system symptoms were more frequent in the exposed cohort and persisted in an adjusted analysis. They were usually transient and may be a true cocaine effect. Abnormal anatomic outcomes previously reported were not confirmed. Increased infections, particularly sexually transmitted diseases, pose a serious public health challenge. Exposure increased involvement of child protective services and out-of-home placement.

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