Respiratory abnormalities in infants of substance-abusing mothers: role of prematurity.
It is a current hypothesis that maternal history of drug addiction during pregnancy and detection of drugs in the urine of the newborn are associated with increased incidence of apnea. To test this hypothesis, we reviewed polygraphic studies of respiration in two groups of infants who had been exposed in utero to cocaine (and other drugs). The first group was composed of 20 term infants (39.1 +/- 0.8 weeks gestation), and premature infants (35.4 +/- 0.8 weeks gestation). None of the infants were on methylxanthines. These infants were matched with 15 term and 15 preterm infants of similar gestational age. Variables studied were: heart rate, respiration, chest impedance pneumography, nasal airflow and oxygen saturation (pulse oximetry). Apnea indices for central and obstructive events of short and long duration as well as periodic breathing and oxygen saturation were obtained. Term drug-exposed infants had less central apnea and a higher rate of periodic breathing compared to term controls, whereas drug-exposed premature infants had more obstructive apnea and less periodic breathing compared to premature controls. These observed differences within groups were subtle and clinically insignificant. Other parameters studied were not different. When term and preterm infants were compared, preterm infants had significantly higher central apnea, obstructive apnea and periodic breathing rates. These differences appeared to be related to gestational age differences, not to drug exposure. There was no evidence that exposure to cocaine and other drugs actually inhibited respiration.
Toubas
P L
PL
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City 73190.
Sekar
K C
KC
Wyatt
E
E
Lawson
A
A
Duke
J C
JC
Parker
M D
MD
D000328:Adult; D000662:Amphetamines; D001049:Apnea / Q000139:chemically induced; D003042:Cocaine; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D002189:Marijuana Abuse; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011248:Pregnancy Complications; D012120:Respiration Disorders / Q000139:chemically induced*; D019966:Substance-Related Disorders
D000662:Amphetamines; D003042:Cocaine