heroin and Fetal-Growth-Retardation

Topics: Abnormalities, Drug-Induced; Female; Fetal Alcohol Spectrum Disorders; Fetal Growth Retardation; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Methadone; Nasopharynx; Phencyclidine; Pregnancy; Pregnancy Complications; Substance Withdrawal Syndrome; Substance-Related Disorders

The aim of the study was to evaluate the effect of substitution therapy in heroin addicted pregnant women on the course of pregnancy, perinatal outcomes and course of the neonatal abstinence syndrome.. A five-year randomised prospective comparative study. The study was carried out in the period of 2002-2007. The group of patients included 147 i.v. heroin-addicted pregnant women. All of them were outpatients of our Perinatal Care Unit. Their daily dose of heroin was approximately lg. Later, 30 women were disqualified from the study for breaking the randomised criteria engagement. The substitution therapy in women who agreed to undergo it, started during the I. trimester of pregnancy. Finally, 47 heroin, 32 methadone and 38 buprenorphine addicted women were enrolled in the study. Birthweight of newborns was compared with the national birthweight tables. Severity and duration of neonatal abstinence syndrome (NAS) were evaluated by Finnegan s score scale.. None of the women delivered before the end of 34th gestational week. We did not encounter any perinatal death or developmental defect. The lowest birthweight, the highest number of newborns with IUGR and the most numerous placental changes were found in the group of heroin-addicted women. The differences compared to the two groups receiving substitution therapy were statistically significant (p < 0.05). The severity and course of NAS were the most severe (p < 0.001) in newborns of women from the methadone group.. Comparison of the groups of outpatients is in many ways questionable because of the restricted possibility of the patients' control. The lifestyle of addicted women has the same impact as the drug use alone. This is probably the main reason for differences in some of the monitored parameters between individual groups. Based on our results we can state that substitution therapy provides pregnant women with the possibility of social stabilization and adequate prenatal care. substitution therapy decreases the street heroin consumption. Methadone notably protracts the newborn's abstinence syndrome. With regard to this fact, attention has been recently focused on substitution with buprenorphine that seems to be from this viewpoint a more considerate option.

Topics: Adult; Birth Weight; Buprenorphine; Female; Fetal Growth Retardation; Heroin; Heroin Dependence; Humans; Infant, Newborn; Life Style; Methadone; Narcotics; Neonatal Abstinence Syndrome; Outpatients; Postpartum Period; Pregnancy; Pregnancy Outcome; Prospective Studies; Severity of Illness Index

Outcomes for 6 pregnant methadone-maintained opiate-dependent subjects in enhanced treatment were compared to those of 6 women receiving conventional methadone maintenance. Enhanced treatment consisted of weekly prenatal care, relapse prevention groups, thrice weekly urine toxicology screening with positive contingency awards for abstinence, and therapeutic child care during treatment visits in addition to treatment as usual. Treatment as usual included daily methadone, group counseling, and random urine toxicology screening. Study patients differed from the comparison group in three important ways, having fewer urine toxicology screens positive for illicit substances (59% vs. 76%), three times as many prenatal visits (8.8 vs. 2.7), and heavier infants (median birth weight, 2959 vs. 2344 grams). These results suggest that enhanced drug treatment can improve pregnancy outcome and, in particular, reduce low birth weight for this high-risk population.

Topics: Adult; Combined Modality Therapy; Female; Fetal Growth Retardation; Follow-Up Studies; Heroin; Heroin Dependence; Humans; Infant, Newborn; Methadone; Neonatal Abstinence Syndrome; Outcome and Process Assessment, Health Care; Patient Care Team; Pregnancy; Pregnancy Complications; Prenatal Care; Recurrence; Social Environment; Substance Abuse Detection

The pre- and postnatal data of 20 pregnant heroin addicts and their neonates are described. 16 women were treated with methadone to prevent withdrawal symptoms. A relatively stabile prenatal condition with a decrease of complications was achieved. On the other hand, the neonates suffered from severe withdrawal symptoms including seizures in spite of intensive paediatric care and prophylactic treatment with barbiturates. After a mean follow-up of one to two years a relatively good neurological development of the children was observed.

Topics: Asphyxia Neonatorum; Cardiotocography; Dose-Response Relationship, Drug; Female; Fetal Growth Retardation; Heroin; Heroin Dependence; HIV Infections; Humans; Infant, Newborn; Methadone; Neonatal Abstinence Syndrome; Neurologic Examination; Pregnancy; Pregnancy Complications; Spasms, Infantile

While cocaine is now used much more frequently than heroin by women of childbearing age, we have found that a significant number of mothers have abused both drugs during their pregnancy. We studied 86 infants who were born to women with a history of cocaine and/or heroin use during pregnancy. The newborns were observed over a 5-day hospital period using a standardized abstinence scoring system and urine drug screening of both mother and infant. Of these, 35 had maternal and/or newborn urine test results that were positive for cocaine only (cocaine group), 14 that were positive for heroin only (heroin group), 17 that were positive for both cocaine and heroin (cocaine/heroin group), and 20 that were negative for both, although the mothers admitted to cocaine use during their pregnancy (cocaine history group). In approximately half of the mother/infant pairs, the results of the urine drug tests were discordant. Microcephaly and growth retardation occurred most frequently in the infants in the cocaine group (17% and 27%, respectively). Microcephaly was also found to be significant in the infants in the cocaine/heroin group. Signs of drug withdrawal occurred in all four drug-exposed groups. Mild withdrawal occurred in 26% of infants in the cocaine group, 21% of the infants in the heroin group, 47% of the infants in the cocaine/heroin group, and in 30% of the infants in the cocaine history group. Withdrawal requiring treatment occurred in 6% of the infants in the cocaine group, 14% of the infants in the heroin group, 35% of infants in the cocaine/heroin group, and 5% of the infants in the cocaine history group. The use of heroin with cocaine has a synergistic effect on the behavior of the newborn.

Topics: Cocaine; Drug Synergism; Female; Fetal Growth Retardation; Heroin; Humans; Infant, Newborn; Microcephaly; Obstetric Labor, Premature; Phenobarbital; Pregnancy; Prenatal Exposure Delayed Effects; Substance Withdrawal Syndrome

The principal obstetrical and paediatric sequelae were studied in 22 heroin addicts who were followed up at Lariboisière Hospital in Paris between 1980 and 1984. The main effects were on the fetus with 45% showing growth retardation below the 10th percentile, 65% fetal distress, 9% prematurity; 33% had infections and 66% had the withdrawal syndrome. Because of this pathology a high number had to be transferred. Considering the period of study, HIV infection could not be evaluated. The most dramatic result seems to be the long-term effect on these children because only a third apparently live with their families and several suffer from abnormalities in psychomotor development.

Topics: Adult; Female; Fetal Distress; Fetal Growth Retardation; Heroin; Heroin Dependence; Humans; Infant, Newborn; Neonatal Abstinence Syndrome; Pregnancy; Pregnancy Complications

Topics: Adult; Female; Fetal Growth Retardation; Heroin; Heroin Dependence; Humans; Methadone; Pregnancy; Pregnancy Complications; Risk; Smoking; Socioeconomic Factors; Substance Withdrawal Syndrome

A group of 13 babies born to heroin-addict mothers has been studied in our Department during the last three years. Authors have recorded clinical features like neonatal abstinence syndrome, malformations, intrauterine growth, maternal age, gestational duration and delivery. They discuss different types of malformations and withdrawal symptoms, and make a comparative study with normal newborns of our hospital.

Topics: Abnormalities, Drug-Induced; Adolescent; Adult; Female; Fetal Growth Retardation; Heroin; Heroin Dependence; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Pregnancy; Pregnancy Complications; Substance Withdrawal Syndrome

A case of poor intrauterine fetal growth is reported, observed during the pregnancy of a 16 years old heroin addicted primigravida. Near on term she was delivered of an almost mature male liveborn of only 37 cm and 1300 g. Our results of placental function-tests with reference to otherwise reported effects of maternal heroin addiction are discussed.

Topics: Adolescent; Female; Fetal Growth Retardation; Heroin; Heroin Dependence; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Maternal-Fetal Exchange; Placenta Diseases; Pregnancy; Pregnancy Complications; Substance Withdrawal Syndrome