Maternal
and neonatal growth, behavior, and physiologic organization were
evaluated in 104 mother-infant pairs with positive results of urine
toxicology screens. ANOVA comparison of cocaine, methamphetamine, and
cocaine plus methamphetamine groups revealed no significant differences
in perinatal variables. The Finnegan withdrawal scoring scheme
demonstrated that all three groups of infants had altered neonatal
behavioral patterns, characterized by abnormal sleep patterns, poor
feeding, tremors, and hypertonia. Infants exposed to cocaine or
methamphetamine or both were combined and compared with both
narcotic-exposed and drug-free mother-infant pairs matched for known
maternal risk factors. All drug-exposed groups had significantly higher
rates of prematurity and intrauterine growth retardation and smaller
head circumferences than did the drug-free comparison group. A
significantly higher rate of placental hemorrhage occurred in the
cocaine plus methamphetamine group. Stepwise multiple regression
analysis assessed the independent contribution of maternal factors;
cocaine or methamphetamine was adversely, negatively assoclated with
gestational age, birth weight, length, and occipitofrontal
circumference. The increased rate of prematurity, intrauterine growth
retardation, and perinatal complications associated with perinatal
exposure to cocaine or methamphetamine was greater than that predicted
by coexisting risk factors and was consistent with the pharmacologic
properties of these drugs.
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