title: Intra-uterine exposure to maternal opiate abuse and HIV: the impact on the developing nervous system.
abstract: BACKGROUND
  Both intra-uterine exposure to maternal drugs and HIV are known to adversely affect the developing central nervous system.
  
  
  OBJECTIVE
  (1) To describe the quality of GMs in infants who were intra-uterinely exposed to maternal opiate abuse and HIV; and (2) to analyze to what extent (a) perinatal events, (b) status of HIV-infection, and (c) the quality of GMs are associated with the neurodevelopmental outcome at 2 to 3years of age.
  
  
  METHODS
  Seventy-seven children intra-uterinely exposed to both maternal opiate abuse and HIV in utero (41 boys and 36 girls; 39 born preterm) were videoed twice: first during the first 2months after term (writhing GMs) and again at 3-5months (fidgety GMs). Neurodevelopmental outcome was assessed at 2-3years of age.
  
  
  RESULTS
  Thirty-eight infants showed abnormal writhing GMs; 25 infants had abnormal or absent fidgety movements; 22 children had an adverse neurodevelopmental outcome. The association between GM trajectories and outcome revealed a Cramer-V=0.75 (p<0.001). Those infants with active HIV-infection (n=10) did not differ from the 67 infants who were HIV-exposed but uninfected with respect to their GM quality or outcome.
  
  
  CONCLUSIONS
  Serial assessment of GMs in infants who were intra-uterinely exposed to maternal opiates and to HIV can be utilized for early identification of infants at a higher risk for later deficits and needing early intervention.
authors.affiliation: Department of Neurology, Paediatric Medical Academy St. Petersburg, Russia.
authors.forename: Alexander B
authors.initials: AB
authors.lastname: Palchik
authors.forename: Christa
authors.initials: C
authors.lastname: Einspieler
authors.forename: Irina V
authors.initials: IV
authors.lastname: Evstafeyeva
authors.forename: Victor B
authors.initials: VB
authors.lastname: Talisa
authors.forename: Peter B
authors.initials: PB
authors.lastname: Marschik
mesh_terms: D002657:Child Development / Q000187:drug effects; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D003932:Heroin / Q000633:toxicity; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008431:Maternal-Fetal Exchange; D009069:Movement Disorders / Q000209:etiology; D009294:Narcotics / Q000633:toxicity; D009293:Opioid-Related Disorders / Q000150:complications*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011297:Prenatal Exposure Delayed Effects / Q000175:diagnosis / Q000209:etiology*
chemical_list: D009294:Narcotics; D003932:Heroin