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Anandan A, Athirah Daud NA, Vicknasingam B, Narayanan S, Azman A, Singh D. Factors associated with drug use during pregnancy and breastfeeding among females who use drugs (FWUDs) in Malaysia. J Ethn Subst Abuse 2021; 22:766-781. [PMID: 34965841 DOI: 10.1080/15332640.2021.2019162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Females who use drugs (FWUDs) are at risk of continuing illicit substance use during pregnancy and breastfeeding. We investigated the prevalence rates and factors associated with these practices in a sample of 200 FWUDs recruited from a publicly-run drug rehabilitation center. A semi-structured questionnaire was used to collect the data. The majority (86%) was Malay (n = 171/200), currently single (71%, n = 141/200), and 51% had nine years of education. The mean age of respondents was 32.2 years (SD = 8.61). Thirty-eight percent (n = 75/200) reported ever using illicit substances during pregnancy, while 15% (n = 30/200) had used them during breastfeeding. Higher odds of using drugs during pregnancy were associated with having an intimate male drug-using partner and with persons who reported abandoning an infant in the past. Lower odds were linked with women who used heroin with ATS (relative to those who used only ATS), and shorter-term ATS (≤3 years) relative to long term ATS users. At a lower level of significance (p = 0.054), being married also lowered the odds. Higher odds of drug use during breastfeeding were associated with having an intimate male drug-using partner, and previous methadone use history, while lower odds were associated with short-term ATS use and being employed. The findings highlight the need for timely and targeted interventions to inform, engage and promote the participation of FWUDs in pre- and post-natal care services.
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Affiliation(s)
- Asnina Anandan
- Centre for Drug Research, Universiti Sains Malaysia, Penang, Malaysia
| | | | | | - Suresh Narayanan
- School of Social Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Azlinda Azman
- School of Social Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Darshan Singh
- Centre for Drug Research, Universiti Sains Malaysia, Penang, Malaysia
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2
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Li JH, Liu JL, Zhang KK, Chen LJ, Xu JT, Xie XL. The Adverse Effects of Prenatal METH Exposure on the Offspring: A Review. Front Pharmacol 2021; 12:715176. [PMID: 34335277 PMCID: PMC8317262 DOI: 10.3389/fphar.2021.715176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/01/2021] [Indexed: 01/12/2023] Open
Abstract
Abuse of methamphetamine (METH), an illicit psychostimulant, is a growing public health issue. METH abuse during pregnancy is on the rise due to its stimulant, anorectic, and hallucinogenic properties. METH can lead to multiple organ toxicity in adults, including neurotoxicity, cardiovascular toxicity, and hepatotoxicity. It can also cross the placental barrier and have long-lasting effects on the fetus. This review summarizes neurotoxicity, cardiovascular toxicity, hepatotoxicity, toxicity in other organs, and biomonitoring of prenatal METH exposure, as well as the possible emergence of sensitization associated with METH. We proposed the importance of gut microbiota in studying prenatal METH exposure. There is rising evidence of the adverse effects of METH exposure during pregnancy, which are of significant concern.
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Affiliation(s)
- Jia-Hao Li
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Jia-Li Liu
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Kai-Kai Zhang
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Li-Jian Chen
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Jing-Tao Xu
- Department of Forensic Clinical Medicine, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Xiao-Li Xie
- Department of Toxicology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China
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Harst L, Deckert S, Haarig F, Reichert J, Dinger J, Hellmund P, Schmitt J, Rüdiger M. Prenatal Methamphetamine Exposure: Effects on Child Development. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:313-319. [PMID: 34140080 DOI: 10.3238/arztebl.m2021.0128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 07/14/2020] [Accepted: 01/19/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND In Germany, the 12-month prevalence of methamphetamine use among persons aged 15 to 34 is 1.9%. An increasing number of newborns are being born after a prenatal methamphetamine exposure (PME). In 2014, in the German state of Saxony, approximately four out of 1000 newborns were affected. METHODS This systematic review (Prospero registration number CRD42017060536) includes publications that were published between January 1990 and November 2019. The purpose was to determine the effects of PME on the peri- and neonatal condition of the affected children and on their further long-term development. Observational studies with a control group were included in the review and examined for their methodological quality. RESULTS 31 publications, which dealt with two prospective and six retrospective cohort studies, were included in the review. The studies involved a total of 4446 mother-child pairs with PME, compared with 43 778 pairs without PME. A metaanalysis revealed that PME was associated with, among other findings, lower birth weight (SMD = -0.348; 95% confidence interval [-0.777; 0.081]), shorter body length (SMD= -0.198 [-0.348; -0.047]), and smaller head circumference (SMD= -0.479 [-1.047; 0.089]). Some differences between the groups with and without PME persist into the toddler years. Moreover, children with PME much more commonly display psychological and neurocognitive abnormalities, which are more severe in children growing up in problematic surroundings (discord, violence, poverty, low educational level of the parent or caregiver). A limitation of this review is that not all studies employed an objective or quantitative measure of methamphet - amine use. CONCLUSION The documented effects of PME on child development necessitate early treatment of the affected expectant mothers, children, and families. Emphasis should be placed on structured and interdisciplinary preventive measures for methamphetamine use.
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Affiliation(s)
- Lorenz Harst
- Center for Evidence-based Healthcare, University Hospital Dresden, Dresden, Germany; Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics, University Hospital Dresden, Dresden, Germany; Center for Feto-Neonatal Health, University Hospital Dresden, Dresden, Germany
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Garey JD, Lusskin SI, Scialli AR. Teratogen update: Amphetamines. Birth Defects Res 2020; 112:1171-1182. [PMID: 32755038 DOI: 10.1002/bdr2.1774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/19/2020] [Accepted: 07/06/2020] [Indexed: 01/09/2023]
Abstract
Amphetamines are synthetic noncatecholamine sympathomimetic amines that act as psychostimulants. They have been prescribed for the treatment of attention-deficit/hyperactivity disorder (ADHD), narcolepsy, and additional health conditions. Amphetamines are also drugs of abuse. Some experimental animal studies suggested adverse developmental effects of amphetamines, including structural malformations. These effects were most often observed in experimental animals at higher dose levels than those used for treatment or abuse and at dose levels that produce maternal toxicity. Controlled studies of amphetamine use for the treatment of ADHD and other indications did not suggest that amphetamines are likely to cause structural malformations, although there are three studies associating medication for ADHD or methamphetamine abuse with gastroschisis. We did not locate studies on the neurobehavioral effects of prenatal exposures to therapeutic amphetamine use. Amphetamine abuse was associated with offspring neurobehavioral abnormalities, but lack of adequate adjustment for confounding interferes with interpretation of the associations. Adverse effects of methamphetamine abuse during pregnancy may be due to factors associated with drug abuse rather than methamphetamine itself. The adverse effects observed in methamphetamine abuse studies may not be extrapolatable to amphetamine medication use.
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Affiliation(s)
- Joan D Garey
- Reproductive Toxicology Center, A Non-Profit Foundation, Washington, District of Columbia, USA
| | - Shari I Lusskin
- Reproductive Toxicology Center, A Non-Profit Foundation, Washington, District of Columbia, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Anthony R Scialli
- Reproductive Toxicology Center, A Non-Profit Foundation, Washington, District of Columbia, USA
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Litzky JF, Deyssenroth MA, Everson TM, Lester BM, Lambertini L, Chen J, Marsit CJ. Prenatal exposure to maternal depression and anxiety on imprinted gene expression in placenta and infant neurodevelopment and growth. Pediatr Res 2018; 83. [PMID: 29538358 PMCID: PMC5959758 DOI: 10.1038/pr.2018.27] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BackgroundDepression and/or anxiety during pregnancy have been associated with impaired fetal growth and neurodevelopment. Because placental imprinted genes play a central role in fetal development and respond to environmental stressors, we hypothesized that imprinted gene expression would be affected by prenatal depression and anxiety.MethodsPlacental gene expression was compared between mothers with prenatal depression and/or anxiety/obsessive compulsive disorder/panic and control mothers without psychiatric history (n=458) in the Rhode Island Child Health Study.ResultsTwenty-nine genes were identified as being significantly differentially expressed between placentae from infants of mothers with both depression and anxiety (n=54), with depression (n=89), or who took perinatal psychiatric medications (n=29) and control mother/infant pairs, with most genes having decreased expression in the stressed group. Among placentae from infants of mothers with depression, we found no differences in expression by medication use, indicating that our results are related to the stressor rather than the treatments. We did not find any relationship between the stress-associated gene expression and neonatal neurodevelopment, as measured using the Neonatal Intensive Care Unit Network Neurobehavioral Scale.ConclusionsThis variation in expression may be part of an adaptive mechanism by which the placenta buffers the infant from the effects of maternal stress.
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Affiliation(s)
- Julia F Litzky
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH
| | - Maya A Deyssenroth
- Department of Environmental Medicine and Public Health; Icahn School of Medicine at Mount Sinai; New York, NY
| | - Todd M Everson
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Barry M. Lester
- Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Providence, RI
| | - Luca Lambertini
- Department of Environmental Medicine and Public Health; Icahn School of Medicine at Mount Sinai; New York, NY,Department of Obstetrics, Gynecology and Reproductive Science; Icahn School of Medicine at Mount Sinai; New York; NY
| | - Jia Chen
- Department of Environmental Medicine and Public Health; Icahn School of Medicine at Mount Sinai; New York, NY,Department of Pediatrics; Icahn School of Medicine at Mount Sinai; New York, NY
| | - Carmen J Marsit
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA,Corresponding Author: Carmen Marsit, 1518 Clifton Road, CNR 202, Atlanta, GA 30322, Phone: (404) 712-8912, Fax: (404) 727-8744,
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Prenatal methamphetamine exposure is associated with reduced subcortical volumes in neonates. Neurotoxicol Teratol 2017; 65:51-59. [PMID: 29069607 DOI: 10.1016/j.ntt.2017.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 10/19/2017] [Accepted: 10/20/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Prenatal exposure to methamphetamine is associated with a range of neuropsychological, behavioural and cognitive deficits. A small number of imaging studies suggests that these may be mediated by neurostructural changes, including reduced volumes of specific brain regions. This study investigated potential volumetric changes in the brains of neonates with prenatal methamphetamine exposure. To our knowledge no previous studies have examined methamphetamine effects on regional brain volumes at this age. STUDY DESIGN Mothers were recruited antenatally and interviewed regarding methamphetamine use during pregnancy. Mothers in the exposure group reported using methamphetamine≥twice/month during pregnancy; control infants had no exposure to methamphetamine or other drugs and minimal exposure to alcohol. MRI scans were performed in the first postnatal month, following which anatomical images were processed using FreeSurfer. Subcortical and cerebellar regions were manually segmented and their volumes determined using FreeView. Pearson correlations were used to analyse potential associations between methamphetamine exposure and regional volumes. The associations between methamphetamine exposure and regional volumes were then examined adjusting for potential confounding variables. RESULTS Methamphetamine exposure was associated with reduced left and right caudate and thalamus volumes. The association in the right caudate remained significant following adjustment for potential confounding variables. CONCLUSIONS Our findings showing reduced caudate and thalamus volumes in neonates with prenatal methamphetamine exposure are consistent with previous findings in older exposed children, and demonstrate that these changes are already detectable in neonates. Continuing research is warranted to examine whether reduced subcortical volumes are predictive of cognitive, behavioural and affective impairment in older children.
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Scott-Goodwin A, Puerto M, Moreno I. Toxic effects of prenatal exposure to alcohol, tobacco and other drugs. Reprod Toxicol 2016; 61:120-30. [DOI: 10.1016/j.reprotox.2016.03.043] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 03/08/2016] [Accepted: 03/28/2016] [Indexed: 01/21/2023]
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Sorsdahl K, Petersen Williams P, Everett-Murphy K, Vythilingum B, de Villiers P, Myers B, Stein DJ. Feasibility and Preliminary Responses to a Screening and Brief Intervention Program for Maternal Mental Disorders Within the Context of Primary Care. Community Ment Health J 2015; 51:962-9. [PMID: 25744699 DOI: 10.1007/s10597-015-9853-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 02/23/2015] [Indexed: 01/08/2023]
Abstract
There is little evidence of the feasibility and acceptability of integrating screening, brief intervention and referral to treatment services that address depression and alcohol, tobacco and other drug (ATOD) use into antenatal care in South Africa. Data were extracted from program records on the number of eligible women screened and number meeting criteria for depression and self-reported ATOD use. 70 women completed a questionnaire examining their preliminary responses and five MOU personnel were interviewed to identify potential barriers to implementation. Of the 3407 eligible women, 1468 (43 %) women were screened for depression or ATOD use, of whom 302 (21.4 %) screened at risk for depression, 388 (26.4 %) disclosed smoking tobacco, and 29 (2 %) disclosed alcohol or other drugs (AOD). Seventy participants completed the three month follow-up interview. Depression scores decreased significantly following the intervention (t (69) = 8.51, p < 0.001) as did self-reported tobacco use (t (73) = 3.45, p < 0.001), however self-reported AOD use remained unchanged.
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Affiliation(s)
- Katherine Sorsdahl
- Alan. J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. .,Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | - Petal Petersen Williams
- Alcohol, Tobacco and Other Drug Research Unit, Medical Research Council, Tygerberg, South Africa
| | - Kathy Everett-Murphy
- Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Bavi Vythilingum
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Bronwyn Myers
- Alcohol, Tobacco and Other Drug Research Unit, Medical Research Council, Tygerberg, South Africa.,Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.,Unit on Anxiety and Stress Disorders, Medical Research Council, Tygerberg, South Africa
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Smith LM, Diaz S, LaGasse LL, Wouldes T, Derauf C, Newman E, Arria A, Huestis MA, Haning W, Strauss A, Della Grotta S, Dansereau LM, Neal C, Lester BM. Developmental and behavioral consequences of prenatal methamphetamine exposure: A review of the Infant Development, Environment, and Lifestyle (IDEAL) study. Neurotoxicol Teratol 2015. [PMID: 26212684 DOI: 10.1016/j.ntt.2015.07.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This study reviews the findings from the Infant Development, Environment, and Lifestyle (IDEAL) study, a multisite, longitudinal, prospective study designed to determine maternal outcome and child growth and developmental findings following prenatal methamphetamine exposure from birth up to age 7.5 years. These findings are presented in the context of the home environment and caregiver characteristics to determine how the drug and the environment interact to affect the outcome of these children. No neonatal abstinence syndrome requiring pharmacologic intervention was observed but heavy drug exposure was associated with increased stress responses in the neonatal period. Poorer inhibitory control was also observed in heavy methamphetamine exposed children placing them at high risk for impaired executive function. Independent of methamphetamine exposure, children with more responsive home environments to developmental and emotional needs demonstrated lower risks for internalizing and externalizing behavior.
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Affiliation(s)
- Lynne M Smith
- Department of Pediatrics, Los Angeles Biomedical Institute at Harbor-UCLA Medical Center and David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
| | - Sabrina Diaz
- Department of Pediatrics, Los Angeles Biomedical Institute at Harbor-UCLA Medical Center and David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Linda L LaGasse
- Pediatrics Division, Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI, USA
| | - Trecia Wouldes
- Department of Psychological Medicine, University of Auckland, New Zealand
| | - Chris Derauf
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Elana Newman
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
| | - Amelia Arria
- Family Science Department, Center on Young Adult Health and Development, University of Maryland School of Public Health, College Park, MD, USA
| | - Marilyn A Huestis
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - William Haning
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Arthur Strauss
- Miller Children's Hospital Long Beach (MCHLB), Long Beach, CA, USA
| | - Sheri Della Grotta
- Pediatrics Division, Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI, USA
| | - Lynne M Dansereau
- Pediatrics Division, Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI, USA
| | - Charles Neal
- Department of Psychological Medicine, University of Auckland, New Zealand
| | - Barry M Lester
- Pediatrics Division, Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI, USA
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Initial feasibility and acceptability of a comprehensive intervention for methamphetamine-using pregnant women in South Africa. PSYCHIATRY JOURNAL 2014; 2014:929767. [PMID: 24829904 PMCID: PMC3994903 DOI: 10.1155/2014/929767] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 10/10/2013] [Indexed: 11/20/2022]
Abstract
The purpose of the present study was to determine the feasibility, acceptability, and initial efficacy of a women-focused intervention addressing methamphetamine use and HIV sexual risk among pregnant women in Cape Town, South Africa. A two-group randomized pilot study was conducted, comparing a women-focused intervention for methamphetamine use and related sexual risk behaviors to a psychoeducational condition. Participants were pregnant women who used methamphetamine regularly, had unprotected sex in the prior month, and were HIV-negative. Primary maternal outcomes were methamphetamine use in the past 30 days, frequency of unprotected sexual acts in the past 30 days, and number of antenatal obstetrical appointments attended. Primary neonatal outcomes were length of hospital stay, birth weight, and gestational age at delivery. Of the 57 women initially potentially eligible, only 4 declined to participate. Of the 36 women who were eligible and enrolled, 92% completed all four intervention sessions. Women in both conditions significantly reduced their methamphetamine use and number of unprotected sex acts. Therefore, delivering comprehensive interventions to address methamphetamine use and HIV risk behaviors among methamphetamine-using pregnant women is feasible in South Africa. Further testing of these interventions is needed to address methamphetamine use in this vulnerable population.
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Barros MCDM, Mitsuhiro SS, Chalem E, Laranjeira RR, Guinsburg R. Depression during gestation in adolescent mothers interferes with neonatal neurobehavior. BRAZILIAN JOURNAL OF PSYCHIATRY 2013; 35:353-9. [PMID: 24402209 DOI: 10.1590/1516-4446-2012-0855] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Accepted: 01/27/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare the neurobehavior of neonates born to adolescent mothers with and without depression during gestation. METHODS This prospective cross-sectional study included healthy term neonates born to adolescent mothers with untreated depression during gestation, without exposure to legal or illicit drugs, and compared them with infants born to adolescent mothers without psychiatric disorders. Maternal psychiatric diagnoses were assessed by the Composite International Diagnostic Interview (CIDI 2.1) and neonatal neurobehavior by the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) at 24 to 72 hours of life. Neurobehavioral outcomes were analyzed by ANOVA adjusted for confounders. RESULTS 37 infants born to mothers with depression during gestation were compared to 332 infants born to mothers without psychiatric disorders. Infants of mothers with depression had smaller head circumferences. Significant interactions of maternal depression and male gender, gestational age > 40 weeks, regional anesthesia during delivery, vaginal delivery, and infant head circumference ≥ 34 cm were found. Worse performance was noted in the following neonatal neurobehavioral parameters: arousal, excitability, lethargy, hypotonicity, and signs of stress and abstinence. CONCLUSION Infants born to adolescent mothers with depression exhibit some behavioral changes in the first days of life. These changes are associated with infant sex, gestational age, type of anesthesia, mode of delivery, and head circumference.
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Affiliation(s)
- Marina Carvalho de Moraes Barros
- Division of Neonatal Medicine, Department of Pediatrics, Universidade Federal de São Paulo - Escola Paulista de Medicina (UNIFESP-EPM), São PauloSP, Brazil
| | - Sandro Sendim Mitsuhiro
- National Science and Technology Institute for Policies on Alcohol and Drugs (INPAD), UNIFESP and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), São PauloSP, Brazil
| | - Elisa Chalem
- Research Unit on Alcohol and Other Drugs, UNIFESP-EPM, São PauloSP, Brazil
| | - Ronaldo Ramos Laranjeira
- National Science and Technology Institute for Policies on Alcohol and Drugs (INPAD), UNIFESP and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), São PauloSP, Brazil
| | - Ruth Guinsburg
- Division of Neonatal Medicine, Department of Pediatrics, Universidade Federal de São Paulo - Escola Paulista de Medicina (UNIFESP-EPM), São PauloSP, Brazil
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Pineda RG, Tjoeng H, Vavasseur C, Kidokoro H, Neil J, Inder T. Patterns of altered neurobehavior in preterm infants within the neonatal intensive care unit. J Pediatr 2013; 162:470-476.e1. [PMID: 23036482 PMCID: PMC3582758 DOI: 10.1016/j.jpeds.2012.08.011] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 06/29/2012] [Accepted: 08/09/2012] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate differences in neurobehavior between preterm infants at term and full-term infants, changes in neurobehavior between 34 weeks postmenstrual age (PMA) and term equivalent in the preterm infant, and the relationship of neurobehavior to perinatal exposures. STUDY DESIGN In this prospective cohort study, 75 infants were tested at 34 weeks PMA and again at term using the Neonatal Intensive Care Unit Network Neurobehavioral Scale. Infants underwent magnetic resonance imaging at term equivalent. Regression was used to investigate differences in the scale's domains of function across time and in relation to perinatal exposures. RESULTS At term equivalent, preterm infants exhibited altered behavior compared with full-term infants, with poorer orientation (P < .001), lower tolerance of handling (P < .001), lower self-regulation (P < .001), poorer reflexes (P < .001), more stress (P < .001), hypertonicity (P < .001), hypotonia (P < .001), and more excitability (P = .007). Preterm infants from 34 weeks PMA to term equivalent, demonstrated changes in motor functions with declining quality of movement (P = .006), increasing hypertonia (P < .001), decreasing hypotonia (P = .001), and changes in behavior with increasing arousal (P < .001), increasing excitability (P < .001), and decreasing lethargy (P < .001). Cerebral injury was associated with more excitability (P = .002). However, no associations were detected between any of the perinatal exposures and developmental change from 34 weeks PMA to term equivalent. CONCLUSION Preterm infants have altered neurobehavior in a broad number of domains at term equivalent. Cerebral injury alters neurobehavior but does not appear to impair early neurobehavioral changes. Important neurobehavioral changes occur before term, and this provides an opportunity for interventions in the neonatal intensive care unit.
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Affiliation(s)
- Roberta G. Pineda
- Program in Occupational Therapy, Washington University School of Medicine, St Louis, Missouri, USA
| | - Han Tjoeng
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA
| | - Claudine Vavasseur
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA
| | - Hiroyuki Kidokoro
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA
| | - Jeffrey Neil
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA,Department of Neurology, Washington University School of Medicine, St Louis, Missouri, USA,Department of Radiology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Terrie Inder
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA,Department of Neurology, Washington University School of Medicine, St Louis, Missouri, USA,Department of Radiology, Washington University School of Medicine, St Louis, Missouri, USA
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Kiblawi ZN, Smith LM, LaGasse LL, Derauf C, Newman E, Shah R, Arria A, Huestis M, DellaGrotta S, Dansereau LM, Neal C, Lester B. The effect of prenatal methamphetamine exposure on attention as assessed by continuous performance tests: results from the Infant Development, Environment, and Lifestyle study. J Dev Behav Pediatr 2013; 34:31-7. [PMID: 23275056 PMCID: PMC3800474 DOI: 10.1097/dbp.0b013e318277a1c5] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess for the increased risk of attention-deficit hyperactivity disorder (ADHD) in young children with prenatal methamphetamine exposure from the multicenter, longitudinal Infant Development, Environment, and Lifestyle (IDEAL) study. METHODS The IDEAL study enrolled 412 mother-infant pairs at 4 sites (Tulsa, OK; Des Moines, IA; Los Angeles, CA; and Honolulu, HI). Methamphetamine-exposed subjects (n = 204) were identified by self-report and/or gas chromatography/mass spectrometry confirmation of amphetamine and metabolites in infant meconium. Matched subjects (n = 208) denied methamphetamine use and had a negative meconium screen. This analysis included a subsample of 301 subjects who were administered the Conners' Kiddie Continuous Performance Test (K-CPT) at 5.5 years of age (153 exposed and 148 comparison). Hierarchical linear models adjusted for covariates tested exposure effects on K-CPT measures. Using the same covariates, logistic regression was used to determine the effect of exposure on the incidence of a positive ADHD confidence index score, defined as greater than 50%. RESULTS There were no differences between the groups in omission or commission errors or reaction time for correct trials. However, methamphetamine exposure was associated with subtle differences in other outcomes predictive of ADHD, including increased slope of reaction time across blocks (p < .001), increased variability in reaction time with longer interstimulus intervals (p < .01), and increased likelihood of greater than 50% on the ADHD confidence index (odds ratio, 3.1; 95% confidence interval, 1.2-7.8; p = .02). CONCLUSION Prenatal methamphetamine exposure was associated with subtle differences in K-CPT scores at 5.5 years of age. Even at this relatively young age, these children exhibit indicators of risk for ADHD and warrant monitoring.
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Affiliation(s)
- Zeina N. Kiblawi
- LABiomed Institute at Harbor-UCLA Medical Center and David Geffen School of Medicine, Los Angeles, CA, USA
| | - Lynne M. Smith
- LABiomed Institute at Harbor-UCLA Medical Center and David Geffen School of Medicine, Los Angeles, CA, USA
| | - Linda L. LaGasse
- Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI, USA
| | - Chris Derauf
- John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Elana Newman
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
| | - Rizwan Shah
- Blank Hospital Regional Child Protection Center - Iowa Health, Des Moines, IA, USA
| | - Amelia Arria
- Center on Young Adult Health and Development, University of Maryland School of Public Health, College Park, MD, USA
| | - Marilyn Huestis
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - Sheri DellaGrotta
- Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI, USA
| | - Lynne M. Dansereau
- Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI, USA
| | - Charles Neal
- John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Barry Lester
- Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI, USA
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Liles BD, Newman E, LaGasse LL, Derauf C, Shah R, Smith LM, Arria AM, Huestis MA, Haning W, Strauss A, DellaGrotta S, Dansereau LM, Neal C, Lester BM. Perceived child behavior problems, parenting stress, and maternal depressive symptoms among prenatal methamphetamine users. Child Psychiatry Hum Dev 2012; 43:943-57. [PMID: 22552952 PMCID: PMC3717339 DOI: 10.1007/s10578-012-0305-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The present study was designed to examine parenting stress, maternal depressive symptoms, and perceived child behavior problems among mothers who used methamphetamine (MA) during pregnancy. Participants were a subsample (n = 212; 75 exposed, 137 comparison) of biological mothers who had continuous custody of their child from birth to 36 months. The subsample was drawn from a larger, ongoing longitudinal study on the effects of prenatal methamphetamine exposure (n = 412; 204 exposed, 208 comparison) (Arria et al in Matern Child Health J 10:293-302 2006). Mothers who used MA during pregnancy reported more parenting stress and more depressive symptoms than a matched comparison group. There were no differences between groups on perceived child behavior problems. In a hierarchical linear model, depressive symptoms, and perceived child behavior problems, but not MA exposure, were statistically significant predictors of parenting stress. Screening for potential parenting problems among mothers with a history of substance abuse is warranted. Parenting interventions targeting depressive symptoms, parenting stress, and child behavior problems are needed for this population.
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Affiliation(s)
- Brandi D. Liles
- Department of Psychology, University of Tulsa, 800 South Tucker Drive, Tulsa, OK 74104-3189, USA
| | - Elana Newman
- Department of Psychology, University of Tulsa, 800 South Tucker Drive, Tulsa, OK 74104-3189, USA
| | - Linda L. LaGasse
- Center for the Study of Children at Risk, Women and Infant’s Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Chris Derauf
- Department of Pediatric & Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Rizwan Shah
- Blank Hospital, Regional Child Protection Center-Children-Iowa Health, Des Moines, IA, USA
| | - Lynne M. Smith
- LABioMed Institute at Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Amelia M. Arria
- Center on Young Adult Health and Development, University of Maryland School of Public Health, College Park, MD, USA
| | - Marilyn A. Huestis
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - William Haning
- John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Arthur Strauss
- Miller Children’s Hospital at Long Beach (MCHLB), Long Beach, CA, USA
| | - Sheri DellaGrotta
- Center for the Study of Children at Risk, Women and Infant’s Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Lynne M. Dansereau
- Center for the Study of Children at Risk, Women and Infant’s Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Charles Neal
- John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Barry M. Lester
- Center for the Study of Children at Risk, Women and Infant’s Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Coyle MG, Salisbury AL, Lester BM, Jones HE, Lin H, Graf-Rohrmeister K, Fischer G. Neonatal neurobehavior effects following buprenorphine versus methadone exposure. Addiction 2012; 107 Suppl 1:63-73. [PMID: 23106928 PMCID: PMC4337995 DOI: 10.1111/j.1360-0443.2012.04040.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
AIM To determine the effects of in utero exposure to methadone or buprenorphine on infant neurobehavior. DESIGN Three sites from the Maternal Opioid Treatment: Human Experimental Research (MOTHER) study, a double-blind, double-dummy, randomized clinical trial participated in this substudy. SETTING Medical Centers that provided comprehensive maternal care to opioid-dependent pregnant women in Baltimore, MD, Providence, RI and Vienna, Austria. PARTICIPANTS Thirty-nine full-term infants. MEASUREMENTS The Neonatal Intensive Care Unit (NICU) Network Neurobehavioral Scale (NNNS) was administered to a subgroup of infants on postpartum days 3, 5, 7, 10, 14-15 and 28-30. FINDINGS While neurobehavior improved for both medication conditions over time, infants exposed in utero to buprenorphine exhibited fewer stress-abstinence signs (P < 0.001), were less excitable (P < 0.001) and less over-aroused (P < 0.01), exhibited less hypertonia (P < 0.007), had better self-regulation (P < 0.04) and required less handling (P < 0.001) to maintain a quiet alert state relative to in utero methadone-exposed infants. Infants who were older when they began morphine treatment for withdrawal had higher self-regulation scores (P < 0.01), and demonstrated the least amount of excitability (P < 0.02) and hypertonia (P < 0.02) on average. Quality of movement was correlated negatively with peak NAS score (P < 0.01), number of days treated with morphine for NAS (P < 0.01) and total amount of morphine received (P < 0.03). Excitability scores were related positively to total morphine dose (P < 0.03). CONCLUSION While neurobehavior improves during the first month of postnatal life for in utero agonist medication-exposed neonates, buprenorphine exposure results in superior neurobehavioral scores and less severe withdrawal than does methadone exposure.
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Affiliation(s)
- Mara G. Coyle
- Department of Pediatrics; The Warren Alpert Medical School of Brown University; Providence; RI; USA
| | | | | | | | - Hai Lin
- Department of Pediatrics; The Warren Alpert Medical School of Brown University; Providence; RI; USA
| | | | - Gabriele Fischer
- Addiction Clinic; Department of Psychiatry and Psychotherapy; Medical University of Vienna, Vienna Austria, Center of Public Health; Vienna; Austria
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Sucharew H, Khoury JC, Xu Y, Succop P, Yolton K. NICU Network Neurobehavioral Scale profiles predict developmental outcomes in a low-risk sample. Paediatr Perinat Epidemiol 2012; 26:344-52. [PMID: 22686386 PMCID: PMC3376022 DOI: 10.1111/j.1365-3016.2012.01288.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Latent profile analysis (LPA) has been used previously to classify neurobehavioral responses of infants prenatally exposed to cocaine and other drugs of abuse. The objective of this study was to define NICU Network Neurobehavioral Scale (NNNS) profile response patterns in a cohort of infants with no known cocaine exposure or other risks for neurobehavior deficits, and determine whether these profiles predict neurobehavioral outcomes in these low-risk infants. METHODS NNNS exams were performed on 355 low-risk infants at approximately 5 weeks after birth. LPA was used to define discrete profiles based on the standard NNNS summary scales. Associations between the infant profiles and neurobehavioral outcomes at one to three years of age were examined. RESULTS Twelve of the 13 summary scales were used and three discrete NNNS profiles identified: social/easy going infants (44%), hypotonic infants (24%), and high arousal/difficult infants (32%). Statistically significant associations between NNNS profiles and later neurobehavioral outcomes were found for psychomotor development and externalizing behaviors. Hypotonic infants had both lower psychomotor development and lower externalizing scores compared to the other two profiles. CONCLUSIONS Three distinct profiles of the NNNS summary scores were identifiable using LPA among infants with no known cocaine exposure. These profile patterns were associated with early childhood neurobehavioral outcome, similar to findings reported in a study of infants with substantial cocaine exposure, demonstrating the utility of this profiling technique in both exposed and unexposed populations.
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Affiliation(s)
- Heidi Sucharew
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, Division of Biostatistics and Epidemiology, Cincinnati, Ohio, United States
| | - Jane C. Khoury
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, Division of Biostatistics and Epidemiology, Cincinnati, Ohio, United States
| | - Yingying Xu
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, Division of General and Community Pediatrics, Cincinnati, Ohio, United States
| | - Paul Succop
- University of Cincinnati, Department of Environmental Health, Division of Epidemiology and Biostatistics, Cincinnati, Ohio, United States
| | - Kimberly Yolton
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, Division of General and Community Pediatrics, Cincinnati, Ohio, United States
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Smith LM, Paz MS, LaGasse LL, Derauf C, Newman E, Shah R, Arria A, Huestis MA, Haning W, Strauss A, Della Grotta S, Dansereau LM, Neal C, Lester BM. Maternal depression and prenatal exposure to methamphetamine: neurodevelopmental findings from the infant development, environment, and lifestyle (ideal) study. Depress Anxiety 2012; 29:515-22. [PMID: 22555777 PMCID: PMC3717341 DOI: 10.1002/da.21956] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 02/07/2012] [Accepted: 03/25/2012] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Maternal depression is associated with a higher incidence of behavioral problems in infants, but the effects of maternal depression as early as 1 month are not well characterized. The objective of this study is to determine the neurobehavioral effects of maternal depression on infants exposed and not exposed to methamphetamine (MA) using the NICU Network Neurobehavioral Scale (NNNS). METHODS Four hundred twelve mother-infant pairs were enrolled (MA = 204) and only biological mothers with custody of their child were included in the current analysis. At the 1-month visit (n = 126 MA-exposed; n = 193 MA-unexposed), the Beck Depression Inventory-II (BDI-II) was administered, and the NNNS was administered to the infant. Exposure was identified by self-report and/or gas chromatography/mass spectroscopy confirmation of amphetamine and metabolites in newborn meconium. Unexposed subjects were matched, denied amphetamine use, and had negative meconium screens. General Linear Models tested the effects of maternal depression and prenatal MA exposure on NNNS, with significance accepted at P < .05. RESULTS The MA group had an increased incidence of depression-positive diagnosis and increased depression scores on the BDI-II. After adjusting for covariates, MA exposure was associated with increased arousal and handling scores, and a decreased ability to self-regulate. Maternal depression was associated with higher autonomic stress and poorer quality of movement. No additional differences were observed in infants whose mothers were both depressed and used MA during pregnancy. CONCLUSIONS Maternal depression is associated with neurodevelopmental patterns of increased stress and decreased quality of movement, suggesting maternal depression influences neurodevelopment in infants as young as 1 month.
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Affiliation(s)
- Lynne M Smith
- Department of Pediatrics, LABioMed Institute at Harbor-UCLA Medical Center and David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
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Vearrier D, Greenberg MI, Miller SN, Okaneku JT, Haggerty DA. Methamphetamine: history, pathophysiology, adverse health effects, current trends, and hazards associated with the clandestine manufacture of methamphetamine. Dis Mon 2012; 58:38-89. [PMID: 22251899 DOI: 10.1016/j.disamonth.2011.09.004] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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19
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Yolton K, Xu Y, Strauss D, Altaye M, Calafat AM, Khoury J. Prenatal exposure to bisphenol A and phthalates and infant neurobehavior. Neurotoxicol Teratol 2011; 33:558-66. [PMID: 21854843 PMCID: PMC3183357 DOI: 10.1016/j.ntt.2011.08.003] [Citation(s) in RCA: 124] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 08/05/2011] [Accepted: 08/07/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To examine the association of prenatal exposure to bisphenol A and select common phthalates with infant neurobehavior measured at 5 weeks. METHODS We compared the concentration of maternal urinary metabolites of bisphenol A and phthalates at two distinct time points in pregnancy (16w, 26w) with scores on the NICU Network Neurobehavioral Scale (NNNS) at 5 weeks of age in a cohort of 350 mother/infant pairs. RESULTS Prenatal exposure to BPA was not significantly associated with neurobehavioral outcomes at 5 weeks. Significant associations between prenatal exposure to measured phthalates and infant neurobehavioral outcomes differed by type of phthalate and were only seen with exposure measured at 26 weeks. Higher total di-butyl phthalate (DBP) metabolites at 26w were associated with improved behavioral organization evidenced by decreased arousal (p=.04), increased self-regulation (p=.052), and decreased handling (p=.02). In males, higher total di-2-ethylhexyl phthalate (DEHP) metabolites at 26w were associated with more nonoptimal reflexes (p=.02). CONCLUSION The association between prenatal phthalate exposure and infant neurobehavior differed by type of phthalate and was evident only with exposure measured at 26w. Prenatal exposure to DBP was associated with improved behavioral organization in 5-week-old infants. Prenatal exposure to DEHP was associated with nonoptimal reflexes in male infants. There was no evidence of an association between prenatal BPA exposure and infant neurobehavior.
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Affiliation(s)
- Kimberly Yolton
- Department of Pediatrics, Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, United States.
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Pregnant and nonpregnant women in cape town, South Africa: drug use, sexual behavior, and the need for comprehensive services. Int J Pediatr 2011; 2011:353410. [PMID: 21541067 PMCID: PMC3083847 DOI: 10.1155/2011/353410] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Accepted: 02/09/2011] [Indexed: 11/17/2022] Open
Abstract
The multiple risks associated with methamphetamine use are of serious concern for women. These risks and consequences are magnified during pregnancy. This secondary analysis of a parent study compared 26 pregnant to 356 nonpregnant women in Cape Town, South Africa, on selected demographic, psychosocial, and HIV-risk domains to identify their treatment service needs. Proportionally, more pregnant than nonpregnant women are using methamphetamine, P = .01, although a very high rate of women used methamphetamine. Women reported similar monthly rates of sexual intercourse, but pregnant women were significantly less likely to report condom use, P < .0001, maintaining their risky behavior. Both groups reported elevated Center for Epidemiological Studies Depression Scale CES-D means, suggesting a need for depression treatment. Results demonstrate a pervasive need for women's comprehensive treatment, regardless of pregnancy status. Moreover, findings support the urgent need for women-focused and pregnancy-specific treatment services for methamphetamine use. Finally, a job-skills training/employment component focus is suggested.
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Piper BJ, Acevedo SF, Kolchugina GK, Butler RW, Corbett SM, Honeycutt EB, Craytor MJ, Raber J. Abnormalities in parentally rated executive function in methamphetamine/polysubstance exposed children. Pharmacol Biochem Behav 2011; 98:432-9. [PMID: 21334365 DOI: 10.1016/j.pbb.2011.02.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 01/30/2011] [Accepted: 02/12/2011] [Indexed: 02/07/2023]
Abstract
Methamphetamine/polysubstance abuse in women of childbearing age is a major concern because of the potential long-term detrimental effects on the brain function of the fetus following in utero exposure. A battery of established tests, including the Wechsler Abbreviated Scale of Intelligence, Conners' Continuous Performance Test II, Behavioral Rating Inventory of Executive Function, the CMS Family Pictures and Dot Location tests, the Spatial Span test from the WISC-IV-Integrated, and a recently developed spatial learning and memory measure (Memory Island), was used to assess the effects of prenatal drug exposure on neurobehavioral performance. Participants were 7 to 9 year old children from similar socioeconomic backgrounds who either had (N=31) or had not (N=35) been exposed to methamphetamine/polysubstance during pregnancy. Compared to unexposed children, exposed children showed pronounced elevations (i.e. more problems) in parental ratings of executive function, including behavioral regulation and metacognition. Exposed children also exhibited subtle reductions in spatial performance in the Memory Island test. In contrast, IQ, Spatial Span, Family Pictures, Dot Location, and vigilance performance were unaffected by prenatal drug exposure history. Thus, children of women who reported using methamphetamine and other recreational drugs during pregnancy showed a selective profile of abnormalities in parentally rated executive function.
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Affiliation(s)
- Brian J Piper
- Methamphetamine Abuse Research Center, ONPRC, Oregon Health and Science University, USA
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Moore DG, Turner JJD, Goodwin JE, Fulton SE, Singer LT, Parrott AC. In-utero exposure to the popular 'recreational' drugs MDMA (Ecstasy) and Methamphetamine (Ice, crystal): preliminary findings. CLINICS IN DEVELOPMENTAL MEDICINE 2011; 188:169-182. [PMID: 35422536 PMCID: PMC9007183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Abstract
OBJECTIVE This study examined the role that easy infant temperament and cumulative environmental risk play in predicting cognitive, language, and behavioral outcomes in 3-year-old children at high social risk. METHODS Subjects were 412 mother-infant dyads, recruited at birth, participating in a longitudinal study examining the effects of prenatal methamphetamine on child development. This analysis includes a subsample (n = 290) of the study with a completed 3-year visit. Temperament was assessed by the Infant Behavior Questionnaire at 12 months. Factor analysis from well-validated measures generated “easy” and “difficult” temperament profiles and a profile for high-risk environment. Caretaker receptive vocabulary served as a proxy for intelligence quotient. Outcomes at 3 years included motor and mental development, behavior problems, and language. Linear regression and hierarchical linear modeling examined the effects of temperament, high-risk environment, and caregiver receptive language on outcomes adjusting for maternal drug use and demographic and socioeconomic covariates. RESULTS Internalizing and externalizing behaviors were lower in children with easy temperament and higher with increased environmental risk. Easy temperament attenuated behavioral problems only in the setting of lower environmental risk. Caregiver receptive language was associated with lower internalizing scores. High-risk environment and temperament factors were not related to cognitive or motor outcomes. Prenatal methamphetamine exposure was not associated with 3-year-old outcomes, nor did it alter the protective effects of an easier temperament on child behavior. CONCLUSIONS CHILDREN growing up in adverse social environments had increased behavioral problems and compromised language development. Conversely, an easy temperament acts as a protective factor for social-emotional development and could be related to resilience.
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PONG KM, ABDEL-LATIF ME, LUI K, WODAK AD, FELLER JM, CAMPBELL T, OEI J. The temporal influence of a heroin shortage on pregnant drug users and their newborn infants in Sydney, Australia. Aust N Z J Obstet Gynaecol 2010; 50:230-6. [DOI: 10.1111/j.1479-828x.2010.01146.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Yolton K, Khoury J, Xu Y, Succop P, Lanphear B, Bernert JT, Lester B. Low-level prenatal exposure to nicotine and infant neurobehavior. Neurotoxicol Teratol 2009; 31:356-63. [PMID: 19619640 PMCID: PMC2761996 DOI: 10.1016/j.ntt.2009.07.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2009] [Revised: 07/09/2009] [Accepted: 07/09/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To examine the association between prenatal exposure to nicotine from tobacco smoke and infant neurobehavior using tobacco biomarkers and a sensitive and comprehensive measure of infant neurobehavior. STUDY DESIGN Participants were 318 infants (206 White, 95 Black, 17 Other) and their mothers. Prenatal tobacco smoke exposure was measured twice during pregnancy and once at delivery using maternal serum cotinine. Infant neurobehavior was assessed with the NICU Network Neurobehavioral Scale at approximately 5 weeks after birth. RESULTS Prenatal tobacco smoke exposure was significantly associated with infant neurobehavior after controlling for important covariates, but the specific behaviors associated with exposure varied by race. In White infants, higher cotinine was associated with increased arousal (p=.030) and excitability (p=.034), and decreased self-regulation (p=.010). In contrast, among Black infants, higher cotinine was associated with decreased arousal (p=.001), excitability (p=.021), and special handling required to complete the assessment (p=.003), and increased self-regulation (p=.021) and hypotonicity (p=.016). In secondary analyses, we found racial differences in the effects of postnatal exposure to second hand smoke and low-level prenatal exposure. CONCLUSIONS Low-level prenatal tobacco smoke exposure is associated with infant neurobehavior at 5 weeks of age, but the specific effects differ by race. These effects may reflect racial differences in nicotine metabolism that are similar to differences reported in adult and child studies of tobacco.
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Affiliation(s)
- Kimberly Yolton
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Division of General and Community Pediatrics, Cincinnati, Ohio 45229-3039, USA.
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