Transient myocardial ischemia in infants prenatally exposed to cocaine.
This prospective study examined whether neonates of pregnant women who used cocaine during pregnancy are at a risk for the development of transient myocardial ischemia and altered autonomic function, as in adults. We studied 21 of 35 infants with a history of prenatal exposure to cocaine. The ST segment changes and heart rate variability were evaluated from three-channel Holter monitors within 48 hours of birth. The data were compared with those on 20 control infants with similar birth weight, gestational age, and postnatal age. Six infants (29%) who were exposed to cocaine in utero had transient ST segment elevation, versus only one infant (5%) from the control group (odds ratio = 7.6; 95% confidence interval, 1.14, 50.64). Heart rates, results of total power and low-frequency power spectral analyses for heart rate variability, and arrhythmias were not significantly different in the two groups. However, a lower ratio of low-to high-frequency power reflected increased vagal activity in cocaine-exposed infants. We conclude that cocaine use in pregnant mothers is associated with transient ST segment abnormalities in their infants. These abnormalities are consistent with transient myocardial ischemia.
Mehta
S K
SK
MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
Finkelhor
R S
RS
Anderson
R L
RL
Harcar-Sevcik
R A
RA
Wasser
T E
TE
Bahler
R C
RC
D003042:Cocaine; D004562:Electrocardiography; D005260:Female; D005333:Fetus / Q000187:drug effects; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D017202:Myocardial Ischemia / Q000139:chemically induced* / Q000175:diagnosis; D011247:Pregnancy; D011248:Pregnancy Complications; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000150:complications*
D003042:Cocaine