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.
MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
S K
SK
Mehta
R S
RS
Finkelhor
R L
RL
Anderson
R A
RA
Harcar-Sevcik
T E
TE
Wasser
R C
RC
Bahler
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