Neurologic findings in neonates with intrauterine cocaine exposure.
To determine the effects of prenatal cocaine exposure on intrauterine growth and neurologic function, 30 term infants were evaluated prospectively: 14 cocaine-exposed and 16 unexposed. Cocaine-exposed infants had significantly lower mean birth weights, birth lengths, and head circumferences than urine-negative controls. Neurologic abnormalities among cocaine-exposed newborns included hypertonia of any type (86% vs 33%), axial hypertonia (79% vs 19%), plantar extension (46% vs 19%), and coarse tremor (57% vs 12%). The degree of hypertonia was sufficiently severe to warrant a diagnosis of "hypertonic tetraparesis" in 64% of cocaine-exposed and 12% of unexposed infants (P = .007). This diagnosis was highly correlated to small head size (r = 0.48; P = .01). Persistent tonic downward gaze was evident in two neurologically abnormal cocaine-exposed newborns. Gaze abnormalities improved slightly over the next 3 weeks of observation. One such infant re-evaluated at 6 months of age revealed resolution of tonic downward gaze and neurologic findings. We conclude that prenatal cocaine exposure is associated with tone and movement abnormalities in newborn infants.
Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York 10032.
C A
CA
Chiriboga
D A
DA
Bateman
J C
JC
Brust
W A
WA
Hauser
D002508:Cephalometry; D003042:Cocaine / Q000009:adverse effects*; D005260:Female; D005317:Fetal Growth Retardation / Q000139:chemically induced / Q000175:diagnosis; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009122:Muscle Hypertonia / Q000139:chemically induced / Q000175:diagnosis; D009357:Neonatal Abstinence Syndrome / Q000175:diagnosis*; D009422:Nervous System Diseases / Q000139:chemically induced* / Q000175:diagnosis; D009460:Neurologic Examination / Q000187:drug effects*; D009468:Neuromuscular Diseases / Q000139:chemically induced / Q000175:diagnosis; D015835:Ocular Motility Disorders / Q000139:chemically induced / Q000175:diagnosis; D011247:Pregnancy; D011712:Pyramidal Tracts / Q000187:drug effects; D011782:Quadriplegia / Q000139:chemically induced / Q000175:diagnosis; D012021:Reflex, Abnormal / Q000187:drug effects
D003042:Cocaine