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Research Article| Volume 18, ISSUE 6, P371-378, December 2003

Psychometric testing of an infant risk assessment for prenatal drug exposure

      There is growing evidence that prenatal drug exposure results in abnormal structural organization and vascular injury of the fetal brain (
      • Morrow C.
      • Bandstra E.
      • Anthony J.
      • Ofir A.
      • Xue L.
      • Reyes M.
      Influence of prenatal cocaine exposure on full term infant neurobehavioral functioning.
      ,
      • Frank D.
      • McCarten K.
      • Robson C.
      • et al.
      Level of in utero cocaine exposure and neonatal ultrasound findings.
      ,
      • Mantovani A.
      • Calamandrei G.
      Delayed developmental effects following prenatal exposure to drugs.
      ,
      • Mayes L.
      Neurobiology of prenatal cocaine exposure effect on developing monoamine systems.
      ,
      • Smith L.
      • Qureshi N.
      • Renslo R.
      • Sinow R.
      Prenatal cocaine exposure and cranial sonographic findings in preterm infants.
      ,
      • Zuckerman B.
      • Brown E.
      Maternal substance abuse and infant development.
      ). These drugs also appear to change the activity of neurons by altering the brain’s neurochemistry (
      • Deutsch S.
      • Mastropaolo J.
      • Rosse R.
      Neurodevelopmental consequences of early exposure to phencyclidine and related drugs.
      ,
      • Heller A.
      • Bubula N.
      • Freeney A.
      • Won L.
      Elevation of fetal dopamine following exposure to methamphetamine in utero.
      ,
      • Won L.
      • Bubula N.
      • Heller A.
      Fetal exposure to methamphetamine in utero stimulates development of serotonergic neurons in three dimensional reaggregate tissue culture.
      ,
      • Zachor D.
      • Moore J.
      • Brezausek C.
      • Theibert A.
      • Percy A.
      Cocaine inhibits NGF-induced PC12 cells differentiation through D(1)-type dopamine receptors.
      ). As the mechanisms underlying drug effects are beginning to be understood, their impact on the drug-exposed infant is apparent, including a variety of neurobehaviors not typically seen in other babies. Tremors, irritability, difficulty being consoled, increased startle response, hypertonicity, poor tracking, lethargy, and decreased interactive behavior have all been noted (
      American Academy of Pediatrics Committee on Drugs
      Neonatal drug withdrawal (RE9746).
      ,
      • Chasnoff I.
      • Griffith D.
      Cocaine Clinical studies of pregnancy and the newborn.
      ,
      • Eyler F.
      • Behnke M.
      • Garvan C.
      • Woods N.
      • Wobie K.
      • Conlon M.
      Newborn evaluations of toxicity and withdrawal related to prenatal cocaine exposure.
      ,
      • Frank D.
      • Augustyn M.
      • Zuckerman B.
      Neonatal neurobehavioral and neuroanatomic correlates of prenatal cocaine exposure Problems of dose and confounding.
      ,
      • Kosofsky B.
      Cocaine-induced alterations in neuro-development.
      ,
      • Lewis K.D.
      ,
      • Lewis K.D.
      • Bennett B.
      • Schmeder N.
      The care of infants menaced by cocaine abuse.
      ).
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      Further reading

        • Bandstra E.
        • Morrow C.
        • Anthony J.
        • Accornero V.
        • Fried P.
        Longitudinal investigation of task persistence and sustained attention in children with prenatal cocaine exposure.
        Neurotoxicology and Teratology. 2001; 23: 545-559
        • Bandstra E.
        • Morrow C.
        • Anthony J.
        • et al.
        Intrauterine growth of full term infants.
        Pediatrics. 2001; 108: 1309-1319