Prenatal drug exposure: infant and toddler outcomes.

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 he...

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Published in:Journal of Addictive Diseases Vol. 29; no. 2; pp. 245 - 259
Main Authors: Bandstra ES, Morrow CE, Mansoor E, Accornero VH
Format: tables/charts Journal Article
Published: Taylor & Francis Ltd Apr-Jun2010
Online Access:View this record in EBSCOhost
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      dt: Apr-Jun2010
      vid: 29
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      pub: Taylor & Francis Ltd
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        atl: Prenatal drug exposure: infant and toddler outcomes.
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        au:
          Bandstra ES
          Morrow CE
          Mansoor E
          Accornero VH
        affil: University of Miami Miller School of Medicine, Department of Pediatrics, Division of Neonatal Medicine, Miami, FL 33101, USA; ebandstr@med.miami.edu
      sug:
        subj:
          Cocaine Adverse Effects
          Infant Development
          Infant, Drug-Exposed
          Neonatal Abstinence Syndrome
          Substance Abuse, Perinatal Complications
          Auditory Perception
          Buprenorphine Therapeutic Use
          Child Development
          Child, Preschool
          Cognition
          Female
          Growth
          Infant
          Infant Behavior
          Infant, Newborn
          Language Development
          Methadone Therapeutic Use
          Narcotics Adverse Effects
          Pregnancy
          Pregnancy Outcomes
          Psychomotor Performance
          Street Drugs Adverse Effects
          Substance Abuse, Perinatal Drug Therapy
          Substance Abuse, Perinatal Prevention and Control
          Visual Perception
          Child, Preschool: 2-5 years
          Infant: 1-23 months
          Infant, Newborn: birth-1 month
          Female
      ab: 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.
      pubtype: Academic Journal
      doctype:
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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