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Impact of Maternal Drug Dependency on Birth Weight and Head Circumference of Offspring

Impact of Maternal Drug Dependency on Birth Weight and Head Circumference of Offspring Abstract • The impact of maternal opiate dependency on birth weight and head circumference of offspring was studied in 150 mother-infant pairs and 150 controls. Mean birth weight and head circumference of drug-dependent offspring were reduced symmetrically compared with drug-free controls of similar socioeconomic status. Although mean gestational ages and rates of prematurity were similar, intrauterine growth retardation occurred in 20% of passively addicted infants vs 4% of controls. A longer period of methadone maintenance was associated with longer gestation and increased birth weight, while higher methadone dosages were associated with higher birth weights and larger head circumferences. Smoking was associated with reduced birth weight by an average of 160 g per pack of cigarettes smoked per day; longer duration of smoking was associated with reductions in both birth weight and head circumference. These data suggest therapeutic strategies to improve these fetal growth characteristics and perhaps improve neurobehavioral outcome of drug-dependent newborns. (AJDC 1987;141:1163-1167) References 1. Finnegan LP: The effect of narcotics and alcohol on pregnancy and the newborn . Ann NY Acad Sci 1981;362:136-157.Crossref 2. Harper RG, Solish GI, Purow HM, et al: The effect of a methadone treatment program upon pregnant heroin addicts and their newborn infants . Pediatrics 1974;54:300-305. 3. Strauss ME, Starr RH, Ostrea EM, et al: Behavioral concomitants of prenatal addiction to narcotics . J Pediatr 1976;89:842-846.Crossref 4. Kandall SR, Albin S, Gartner LM, et al: The narcotic dependent mother: Fetal and neonatal consequences . Early Hum Dev 1977;1/2:159-169.Crossref 5. Kandall SR, Albin S, Lowinson J, et al: Differential effects of maternal heroin and methadone use on birthweight . Pediatrics 1976;58: 681-685. 6. Chasnoff IJ, Hatcher R, Burns WJ: Polydrug and methadone addicted newborns: A continuum of impairment . Pediatrics 1982;70:210-213. 7. Rosen TS, Johnson HL: Children of methadone maintained mothers: Follow-up to 18 months of age . J Pediatr 1982;101:192-196.Crossref 8. Lifschitz MH, Wilson GS, Smith EO, et al: Fetal and postnatal growth of children born to narcotic-dependent women . J Pediatr 1983;102: 686-691.Crossref 9. Lifschitz MH, Wilson GS, Smith EO, et al: Factors affecting head growth and intellectual function in children of drug addicts . Pediatrics 1985;75:269-274. 10. Villar J, Smeriglio V, Martorell R, et al: Heterogeneous growth and mental development of intrauterine growth retarded infants during the first three years of life . Pediatrics 1984;74: 783-791. 11. Fitzhardinge PM, Steven EM: The small for date infant: II. Neurological and intellectual sequelae . Pediatrics 1972;50:50-57. 12. Harvey D, Prince J, Bunton J, et al: Abilities of children who were small for gestational age babies . Pediatrics 1982;69:296-300. 13. Gross SJ, Kosmetates N, Grimes CT, et al: Newborn head size and neurologic status: Predictors of growth and development of low birth weight infants . AJDC 1978;132:753-756. 14. Gross SJ, Oehler JM, Eckerman CO: Head growth and developmental outcome in very-low-birth-weight infants . Pediatrics 1983;71:70-75. 15. Kandall SR, Doberczak TM, Mauer KR, et al: Opiate v CNS depressant therapy in neonatal drug abstinence syndrome . AJDC 1983;137: 378-382. 16. Dubowitz LM, Dubowitz V, Goldberg C: Clinical assessment of gestational age in the newborn infant . J Pediatr 1970;77:1-10.Crossref 17. Fleiss J: The design and analysis of clinical experiments . New York, John Wiley & Sons Inc, 1986, p 104. 18. Remington RD, Schork MA: Statistics with applications to the biological and health sciences . Englewood Cliffs, NJ, Prentice-Hall International Inc, 1970, p 234. 19. Woods DL, Malan AF, Heese H: Patterns of retarded fetal growth . Early Hum Dev 1979;3: 257-262.Crossref 20. Naeye RL, Blanc W, Leblanc W, et al: Fetal complications of maternal heroin addiction: Abnormal growth, infection, and episodes of stress . J Pediatr 1973;83:1055-1061.Crossref 21. Glass L, Rajegowda BK, Mukherjae TK: Effects of heroin on corticosteroid production in pregnant addicts and their fetuses . Am J Obstet Gynecol 1973;117:416-418. 22. Vassalle M: Role of catecholamine release in morphine hyperglycemia . Am J Physiol 1961; 200:530-534. 23. Borison HL, Fishburn BR, Bhide NK, et al: Morphine-induced hyperglycemia in the cat . J Pharmacol Exp Ther 1962;138:229-235. 24. Kliegman RM, King KC: Intrauterine growth retardation determinants of aberrant fetal growth , in Behrman F (ed): Neonatal-Perinatal Medicine St Louis, CV Mosby Co, 1983, pp 49-80. 25. Naeye R: Influence of maternal cigarette smoking during pregnancy on fetal and childhood growth . Obstet Gynecol 1981;57:18-20. 26. Sexton MS, Hebel R: A clinical trial of change in maternal smoking and its effect on birth weight . JAMA 1984;251:911-915.Crossref 27. Naeye RL: The duration of maternal cigarette smoking, fetal and placental disorders . Early Hum Dev 1979;3/3:229-237.Crossref 28. Clarren SK, Smith DW: The fetal alcohol syndrome . N Engl J Med 1978;298:1063-1067.Crossref 29. Gordis E, Kreek MJ: Alcoholism and drug addiction in pregnancy . Curr Probl Obstet Gynecol Fertil 1977;1:5-48. 30. Koops BL, Morgan LJ, Battaglia FC: Neonatal mortality risk in relation to birth weight and gestational age: Update . J Pediatr 1982;101: 969-977.Crossref 31. Lipper E, Lee K, Gartner LM, et al: Determinants of neurobehavioral outcome in low-birth-weight infants . Pediatrics 1981;67:502-505. 32. Wilson GS, Desmond MM, Wait RB: Follow-up of methadone-treated and untreated narcotic-dependent women and their infants: Health, developmental, and social implications . J Pediatr 1981;93:716-722.Crossref 33. Kaltenbach K, Graziani LJ, Finnegan LP: Methadone exposure in utero: Developmental status at 1 and 2 years of age . Pharmacol Biochem Behav 1979:11( (suppl) )15-17. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Impact of Maternal Drug Dependency on Birth Weight and Head Circumference of Offspring

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1987.04460110033016
Publisher site
See Article on Publisher Site

Abstract

Abstract • The impact of maternal opiate dependency on birth weight and head circumference of offspring was studied in 150 mother-infant pairs and 150 controls. Mean birth weight and head circumference of drug-dependent offspring were reduced symmetrically compared with drug-free controls of similar socioeconomic status. Although mean gestational ages and rates of prematurity were similar, intrauterine growth retardation occurred in 20% of passively addicted infants vs 4% of controls. A longer period of methadone maintenance was associated with longer gestation and increased birth weight, while higher methadone dosages were associated with higher birth weights and larger head circumferences. Smoking was associated with reduced birth weight by an average of 160 g per pack of cigarettes smoked per day; longer duration of smoking was associated with reductions in both birth weight and head circumference. These data suggest therapeutic strategies to improve these fetal growth characteristics and perhaps improve neurobehavioral outcome of drug-dependent newborns. (AJDC 1987;141:1163-1167) References 1. Finnegan LP: The effect of narcotics and alcohol on pregnancy and the newborn . Ann NY Acad Sci 1981;362:136-157.Crossref 2. Harper RG, Solish GI, Purow HM, et al: The effect of a methadone treatment program upon pregnant heroin addicts and their newborn infants . Pediatrics 1974;54:300-305. 3. Strauss ME, Starr RH, Ostrea EM, et al: Behavioral concomitants of prenatal addiction to narcotics . J Pediatr 1976;89:842-846.Crossref 4. Kandall SR, Albin S, Gartner LM, et al: The narcotic dependent mother: Fetal and neonatal consequences . Early Hum Dev 1977;1/2:159-169.Crossref 5. Kandall SR, Albin S, Lowinson J, et al: Differential effects of maternal heroin and methadone use on birthweight . Pediatrics 1976;58: 681-685. 6. Chasnoff IJ, Hatcher R, Burns WJ: Polydrug and methadone addicted newborns: A continuum of impairment . Pediatrics 1982;70:210-213. 7. Rosen TS, Johnson HL: Children of methadone maintained mothers: Follow-up to 18 months of age . J Pediatr 1982;101:192-196.Crossref 8. Lifschitz MH, Wilson GS, Smith EO, et al: Fetal and postnatal growth of children born to narcotic-dependent women . J Pediatr 1983;102: 686-691.Crossref 9. Lifschitz MH, Wilson GS, Smith EO, et al: Factors affecting head growth and intellectual function in children of drug addicts . Pediatrics 1985;75:269-274. 10. Villar J, Smeriglio V, Martorell R, et al: Heterogeneous growth and mental development of intrauterine growth retarded infants during the first three years of life . Pediatrics 1984;74: 783-791. 11. Fitzhardinge PM, Steven EM: The small for date infant: II. Neurological and intellectual sequelae . Pediatrics 1972;50:50-57. 12. Harvey D, Prince J, Bunton J, et al: Abilities of children who were small for gestational age babies . Pediatrics 1982;69:296-300. 13. Gross SJ, Kosmetates N, Grimes CT, et al: Newborn head size and neurologic status: Predictors of growth and development of low birth weight infants . AJDC 1978;132:753-756. 14. Gross SJ, Oehler JM, Eckerman CO: Head growth and developmental outcome in very-low-birth-weight infants . Pediatrics 1983;71:70-75. 15. Kandall SR, Doberczak TM, Mauer KR, et al: Opiate v CNS depressant therapy in neonatal drug abstinence syndrome . AJDC 1983;137: 378-382. 16. Dubowitz LM, Dubowitz V, Goldberg C: Clinical assessment of gestational age in the newborn infant . J Pediatr 1970;77:1-10.Crossref 17. Fleiss J: The design and analysis of clinical experiments . New York, John Wiley & Sons Inc, 1986, p 104. 18. Remington RD, Schork MA: Statistics with applications to the biological and health sciences . Englewood Cliffs, NJ, Prentice-Hall International Inc, 1970, p 234. 19. Woods DL, Malan AF, Heese H: Patterns of retarded fetal growth . Early Hum Dev 1979;3: 257-262.Crossref 20. Naeye RL, Blanc W, Leblanc W, et al: Fetal complications of maternal heroin addiction: Abnormal growth, infection, and episodes of stress . J Pediatr 1973;83:1055-1061.Crossref 21. Glass L, Rajegowda BK, Mukherjae TK: Effects of heroin on corticosteroid production in pregnant addicts and their fetuses . Am J Obstet Gynecol 1973;117:416-418. 22. Vassalle M: Role of catecholamine release in morphine hyperglycemia . Am J Physiol 1961; 200:530-534. 23. Borison HL, Fishburn BR, Bhide NK, et al: Morphine-induced hyperglycemia in the cat . J Pharmacol Exp Ther 1962;138:229-235. 24. Kliegman RM, King KC: Intrauterine growth retardation determinants of aberrant fetal growth , in Behrman F (ed): Neonatal-Perinatal Medicine St Louis, CV Mosby Co, 1983, pp 49-80. 25. Naeye R: Influence of maternal cigarette smoking during pregnancy on fetal and childhood growth . Obstet Gynecol 1981;57:18-20. 26. Sexton MS, Hebel R: A clinical trial of change in maternal smoking and its effect on birth weight . JAMA 1984;251:911-915.Crossref 27. Naeye RL: The duration of maternal cigarette smoking, fetal and placental disorders . Early Hum Dev 1979;3/3:229-237.Crossref 28. Clarren SK, Smith DW: The fetal alcohol syndrome . N Engl J Med 1978;298:1063-1067.Crossref 29. Gordis E, Kreek MJ: Alcoholism and drug addiction in pregnancy . Curr Probl Obstet Gynecol Fertil 1977;1:5-48. 30. Koops BL, Morgan LJ, Battaglia FC: Neonatal mortality risk in relation to birth weight and gestational age: Update . J Pediatr 1982;101: 969-977.Crossref 31. Lipper E, Lee K, Gartner LM, et al: Determinants of neurobehavioral outcome in low-birth-weight infants . Pediatrics 1981;67:502-505. 32. Wilson GS, Desmond MM, Wait RB: Follow-up of methadone-treated and untreated narcotic-dependent women and their infants: Health, developmental, and social implications . J Pediatr 1981;93:716-722.Crossref 33. Kaltenbach K, Graziani LJ, Finnegan LP: Methadone exposure in utero: Developmental status at 1 and 2 years of age . Pharmacol Biochem Behav 1979:11( (suppl) )15-17.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Nov 1, 1987

References

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