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.
Chiriboga
C A
CA
Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York 10032.
Bateman
D A
DA
Brust
J C
JC
Hauser
W A
WA
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