heroin and Developmental-Disabilities

Although substance use has been a worldwide problem at all levels of society since ancient times, recent attention has been focused on the use of legal and illegal substances by the pregnant woman. Almost all drugs taken by the pregnant woman are known to cross the placenta and have some effect on the fetus. This article reviews the effects of the drugs most frequently used by pregnant women in the United States--nicotine, alcohol, marijuana, opiates, and cocaine--on the fetus and neonate; when possible, information regarding long-term medical problems is included.

Topics: Cannabis; Child; Child, Preschool; Congenital Abnormalities; Developmental Disabilities; Female; Health Promotion; Heroin; Humans; Infant; Infant, Newborn; Male; Methadone; Pregnancy; Pregnancy Outcome; Prenatal Exposure Delayed Effects; Substance-Related Disorders; United States

Topics: Child; Child, Preschool; Cocaine; Developmental Disabilities; Ethanol; Female; Heroin; Humans; Infant; Infant, Newborn; Male; Maternal-Fetal Exchange; Pregnancy; Substance-Related Disorders

This paper reviews the literature regarding the development of children up to age 6 years who were born to mothers addicted to heroin or methadone. These children are compared with children born to nonaddicted mothers to determine whether there were any differences between the two groups related to maternal drug addiction. This paper discusses the obstetrical and medical complications associated with maternal drug addiction and their effects on the prognosis of the infant at delivery.

Topics: Child; Child Behavior Disorders; Child, Preschool; Developmental Disabilities; Female; Heroin; Humans; Infant; Infant, Newborn; Methadone; Neonatal Abstinence Syndrome; Pregnancy

This paper reviews neonatal and developmental behavioral characteristics of children born to heroin- and methadone-addicted women. Evidence of behavioral effects is clearer and more consistent for the neonatal period than in later infancy and childhood. It has not been shown that additional risk for psychological disturbance in childhood is contributed by passive addiction in utero. Methodologic problems in this literature are described and suggestions for strategies and directions in research are offered.

Topics: Child Behavior Disorders; Developmental Disabilities; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Methadone; Psychiatric Status Rating Scales; Substance Withdrawal Syndrome

Study aims to examine development in infants following prenatal heroin, methadone, and opioid exposure, which adversely affects central and autonomic nervous systems. Abrupt discontinuation results in neurologic and behavioral findings as Neonatal Abstinence Syndrome (NAS).. Following NAS treatment, 28 infants (mean age 55 days [range 21-98 days], 57% male) were assessed using Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) Cognitive, Language, and Motor subscales. Outcomes were compared with a historical control.. Mean Language and Cognition scores were significantly lower (P < .001) in the NAS group. Distributions of scores for Language (P < .001) and Cognition (P = .022) were also significantly different between NAS and historical control groups.. Prenatal heroin, methadone, and other opioid exposure is associated with weaknesses in language and cognition. This information has important public health implications, drawing attention to an otherwise healthy infant population which may benefit from early intervention services.

Topics: Analgesics, Opioid; Child Development; Developmental Disabilities; Female; Heroin; Humans; Infant; Infant, Newborn; Male; Methadone; Neonatal Abstinence Syndrome; Neuropsychological Tests; Pregnancy; Prenatal Exposure Delayed Effects

Both intra-uterine exposure to maternal drugs and HIV are known to adversely affect the developing central nervous system.. (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.. 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.. 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.. 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.

Topics: Child Development; Developmental Disabilities; Female; Heroin; HIV Infections; Humans; Infant, Newborn; Infant, Premature; Male; Maternal-Fetal Exchange; Movement Disorders; Narcotics; Opioid-Related Disorders; Pregnancy; Pregnancy Complications, Infectious; Prenatal Exposure Delayed Effects

Morphometric cerebral characteristics were studied in children with prenatal poly-substance exposure (n=14) compared to controls (n=14) without such exposure. Ten of the substance-exposed children were born to mothers who used opiates (heroin) throughout the pregnancy. Groups were compared across 16 brain measures: cortical gray matter, cerebral white matter, hippocampus, amygdala, thalamus, accumbens area, caudate, putamen, pallidum, brainstem, cerebellar cortex, cerebellar white matter, lateral ventricles, inferior lateral ventricles, and the 3rd and 4th ventricles. In addition, continuous measurement of thickness across the entire cortical mantle was performed. Volumetric characteristics were correlated with ability and questionnaire assessments 2 years prior to scan. Compared to controls, the substance-exposed children had smaller intracranial and brain volumes, including smaller cerebral cortex, amygdala, accumbens area, putamen, pallidum, brainstem, cerebellar cortex, cerebellar white matter, and inferior lateral ventricles, and thinner cortex of the right anterior cingulate and lateral orbitofrontal cortex. Pallidum and putamen appeared especially reduced in the subgroup exposed to opiates. Only volumes of the right anterior cingulate, the right lateral orbitofrontal cortex and the accumbens area, showed some association with ability and questionnaire measures. The sample studied is rare and hence small, so conclusions cannot be drawn with certainty. Morphometric group differences were observed, but associations with previous behavioral assessment were generally weak. Some of the volumetric differences, particularly thinner cortex in part of the right lateral orbitofrontal cortex, may be moderately involved in cognitive and behavioral difficulties more frequently experienced by opiate and poly-substance-exposed children.

Topics: Attention Deficit Disorder with Hyperactivity; Brain; Cerebral Cortex; Child; Child Behavior Disorders; Child, Preschool; Developmental Disabilities; Dominance, Cerebral; Female; Follow-Up Studies; Heroin; Humans; Illicit Drugs; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Intelligence; Internal-External Control; Learning Disabilities; Magnetic Resonance Imaging; Male; Narcotics; Neuropsychological Tests; Pregnancy; Prenatal Exposure Delayed Effects; Reference Values; Social Adjustment; Statistics as Topic; Wechsler Scales

In the present investigation we were interested to study the possible role of in-utero exposure to heroin and of the home environmental in the etiology of long-term developmental problems in children born to heroin-dependent parents in comparison to matched controls. The children were examined at .5-6 years of age by a developmental pediatrician and a developmental psychologist using, for the children up to 2.5 years of age, the Bayley Developmental Scales, and for children aged 3-6 years the McCarthy Scales for Children's Abilities. We examined 83 children born to heroin-dependent mothers, and compared the results to those of 76 children born to heroin-dependent fathers and to three control groups; 50 children with environmental deprivation, 50 normal children from families of moderate or high socioeconomic class, without environmental deprivation, and 80 healthy children from kindergartens in Jerusalem. There were five children (6.0%) with significant neurological damage among the children born to heroin-dependent mothers and six (7.9%) children among those born to heroin-dependent fathers. The children born to heroin-dependent mothers had a lower birth weight and a lower head circumference at examination when compared to controls. The children born to heroin-dependent parents also had a high incidence of hyperactivity, inattention, and behavioral problems. The lowest DQ or IQ among the children with cognitive levels above 70 was found in the children with environmental deprivation, next was the DQ or IQ of children born to heroin-dependent fathers, then the DQ or IQ of the children born to heroin-dependent mothers. When the children born to heroin-dependent mothers were divided to those that were adopted at a very young age and to those raised at home, the adopted children were found to function similarly to the controls while those not adopted functioned significantly lower. Our results show that the developmental delay and behavioral disorders observed among children born to drug-dependent parents raised at home may primarily result from severe environmental deprivation and the fact that one or both parents are addicted. The specific role of the in-utero heroin exposure in the determination of the developmental outcome of these children (if they do not have significant neurological damage), seems to be less important in comparison to the home environment.

Topics: Abnormalities, Drug-Induced; Birth Weight; Case-Control Studies; Child; Child of Impaired Parents; Child, Preschool; Developmental Disabilities; Family Health; Fathers; Female; Growth; Heroin; Heroin Dependence; Humans; Infant; Infant, Newborn; Israel; Male; Mothers; Neonatal Abstinence Syndrome; Pregnancy; Prenatal Exposure Delayed Effects; Psychosocial Deprivation; Sex Ratio; Social Class