heroin and Infant--Newborn--Diseases

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

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

Topics: Adrenocortical Hyperfunction; Animals; Blood Transfusion, Intrauterine; Congenital Hypothyroidism; Erythroblastosis, Fetal; Estrogens; Ethanol; Extraembryonic Membranes; Female; Fetal Diseases; Fetus; Glucocorticoids; Heroin; Humans; Hyaline Membrane Disease; Hydrocortisone; Hypoprothrombinemias; Infant, Newborn; Infant, Newborn, Diseases; Isoxsuprine; Jaundice, Neonatal; Lung; Maternal-Fetal Exchange; Phenobarbital; Pregnancy; Pulmonary Surfactants; Rabbits; Rats; Thyroxine; Vitamin D

Topics: Apgar Score; Behavior; Blood; Brain; Brain Chemistry; Central Nervous System; Child Development; DNA; Embryonic and Fetal Development; Female; Fetus; Gestational Age; Heroin; Hormones; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Lysergic Acid Diethylamide; Mother-Child Relations; Neurologic Examination; Neurologic Manifestations; Placentation; Pregnancy; Tranquilizing Agents; Umbilical Cord

Topics: Amphetamine; Animals; Autistic Disorder; Behavior, Animal; Catecholamines; Child; Child Behavior; Child Behavior Disorders; Child, Preschool; Chlorpromazine; Clinical Trials as Topic; Dextroamphetamine; Female; Heroin; Humans; Hyperkinesis; Infant, Newborn; Infant, Newborn, Diseases; Learning; Liver; Maternal-Fetal Exchange; Phenothiazines; Placebos; Pregnancy; Pregnancy Complications; Psychopharmacology; Reticular Formation; Schizophrenia, Childhood; Substance Withdrawal Syndrome

Topics: Anti-Bacterial Agents; Coumarins; Female; Fetal Diseases; Fetus; Hemolysin Proteins; Heroin; Hormones; Humans; Infant, Newborn; Infant, Newborn, Diseases; Pregnancy; Pregnancy Complications; Reserpine; Sulfonamides; Toxicology

Topics: Amphetamine; Animals; Autistic Disorder; Behavior, Animal; Catecholamines; Child; Child Behavior; Child Behavior Disorders; Child, Preschool; Chlorpromazine; Clinical Trials as Topic; Dextroamphetamine; Female; Heroin; Humans; Hyperkinesis; Infant, Newborn; Infant, Newborn, Diseases; Learning; Liver; Maternal-Fetal Exchange; Phenothiazines; Placebos; Pregnancy; Pregnancy Complications; Psychopharmacology; Reticular Formation; Schizophrenia, Childhood; Substance Withdrawal Syndrome

Topics: Chlorpromazine; Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Phenobarbital; Substance Withdrawal Syndrome; Substance-Related Disorders

Transient hypothyroxinemia is common in infants less than 30 wk gestation and is associated with neurodevelopmental deficits. Reductions in T4 and T3 levels with TSH unchanged are the key features of severe illness using surrogate indices of overall severity of illness, but these do not inform the impact of individual disease conditions or drug use.. Our objective was to investigate the contribution of postnatal factors to the variations in serum levels of iodothyronines, thyroid-binding globulin, and TSH.. We recruited a cohort of infants (23-34 wk gestation; n = 780) between January 1998 and September 2001.. The study involved 11 level III Scottish neonatal intensive care units and included cohorts of infants delivered at 23-34 wk gestation.. We assessed serum levels of iodothyronines, thyroid-binding globulin, and TSH at 7, 14, and 28 d adjusted for the potentially significant postnatal influences (n = 31).. Serum levels of TSH, free T4, T3, and T4 are variably but significantly associated with bacteremia, endotracheal bacterial cultures, persistent ductus arteriosus, necrotizing enterocolitis, cerebral ultrasonography changes, oxygen dependence at 28 d, and the use of aminophylline, caffeine, dexamethasone, diamorphine, and dopamine.. There are many more associations of postnatal factors with transient hypothyroxinemia than had previously been considered in preterm infants. Alternative strategies should be considered for correction of hypothyroxinemia rather than sole reliance on the direct therapy of hormone replacement. A more oblique preventative approach may be necessary through reduction in the incidence or severity of individual illness(es). Similarly, alternatives to those drugs that interfere with the hypothalamic-pituitary-thyroid axis should be evaluated (e.g. other inotropics instead of dopamine).

Topics: Aminophylline; Bacterial Infections; Caffeine; Dexamethasone; Dopamine; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Thyroid Hormones; Thyroxine

Illicit drug taking in Australia, with its attendant social and medical consequences, is increasing and the effects extend to maternity hospitals where infants born to addicted mothers have more health problems in the neonatal period. The aims of this study were to evaluate (1) the patterns of illness of such infants and (2) the burden imposed on the neonatal department of a large tertiary maternity centre.. An audit was conducted of all Chemical Dependency Unit (CDU) mothers and babies delivered at the Royal Women's Hospital, Melbourne, Australia during 1997. Data were compared with those from a concurrent control group of mothers and babies randomly generated from the hospital's obstetric database.. Ninety-six infants born to CDU mothers were compared with a control group of 200 infant/mother pairs. The majority of women in the CDU clinic were treated for narcotic addiction with methadone (90%) but most continued to use heroin during pregnancy (68%). Infants born to CDU mothers were significantly less mature and lighter than control infants. Fifty-three (55%) CDU infants required admission to the Special Care Nursery either because of neonatal abstinence syndrome (n = 29) or other medical reasons (n = 24). The median length of hospital stay was significantly longer in CDU compared with control infants (8 vs 3 days, P < 0.01).. Infants born to drug dependent mothers have more neonatal problems requiring specialized medical and nursing expertise, compared with control infants. These infants are large consumers of scarce health resources.

Topics: Adult; Ambulatory Care Facilities; Amphetamines; Australia; Benzodiazepines; Cannabis; Cocaine; Comorbidity; Female; Health Resources; Heroin; Hospitals, Urban; Humans; Incidence; Infant, Newborn; Infant, Newborn, Diseases; Length of Stay; Lysergic Acid Diethylamide; Male; Maternal-Fetal Exchange; Medical Audit; Methadone; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects; Substance-Related Disorders

Topics: Adult; Child Behavior Disorders; Child Development; Child, Preschool; Female; Follow-Up Studies; Heroin; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Methadone; Pregnancy; 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

Topics: Adult; Apnea; Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Lysergic Acid Diethylamide; Morphine; Pentazocine; Pregnancy; Pregnancy Complications; Respiration, Artificial; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Child Development; Female; Heroin; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Methadone; Opioid-Related Disorders; Pregnancy; Substance Withdrawal Syndrome

Blood pressure and plasma renin activity were studied in 13 infants of drug-dependent mothers (heroin and/or methadone) and 20 control newborns for a period of 21 days. Urinary excretion of epinephrine and norepinephrine were also measured at 24 and 48 h of age. The systolic blood pressure was found to be significantly elevated in newborns of drug-dependent mothers compared with controls (p less than 0.01), but diastolic blood pressure levels were similar. Plasma renin activity was significantly elevated (p less than 0.001) at 48-72 h and urinary epinephrine levels were significantly lower (p less than 0.05) at 24-48 h of age in the drug group, and norepinephrine levels were equivalent. Systolic hypertension and elevated plasma renin activity in these newborns of dependent mothers may be due to increased beta-adrenergic receptor sensitivity.

Topics: Catecholamines; Diastole; Female; Heroin; Humans; Hypertension; Infant, Newborn; Infant, Newborn, Diseases; Male; Methadone; Pregnancy; Receptors, Adrenergic, beta; Renin; Substance Withdrawal Syndrome; Systole

Management of 50 experimental newborn infants ill with narcotic withdrawal has been carried out with the aid of an instrument developed for measuring its severity, the Neonatal Narcotic Withdrawal Index (NNWI). With its use, infants exposed to methadone in utero have been successfully cared for with detoxification needed in less than 25% of cases and for durations of less than 2 weeks. The percentage of cases and the length of treatment is much less than is customary for infants who have been prenatally exposed to similar doses of methadone. Validity of the NNWI is shown by the statistically significant difference between the mean scores for experimental and control subjects, a high significant correlation between simultaneously measured scores by separate examiners, statistically significant correlations between subscores and total withdrawal scores for the narcotic-exposed experimental cases, and for this group, a statistically significant correlation between scores of withdrawal and the maternal dose of methadone. The simplicity of the NNWI should help to make it acceptable for use by physicians.

Topics: Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Methadone; Opium; Pregnancy; Psychological Tests; Substance Withdrawal Syndrome

Newborn infants, chronically exposed in utero to low doses of methadone with or without concomitant heroin, display more rapid eye movement sleep and less quiet sleep than control infants, while babies fetally exposed to both opiates and nonopiates have less organization of sleep states. Other perinatal factors, such as birth weight and gestational age, are related more to the amount of fetal drug exposure than to the type.

Topics: Birth Weight; Female; Heroin; Heroin Dependence; Humans; Infant, Newborn; Infant, Newborn, Diseases; Maternal-Fetal Exchange; Methadone; Nervous System Diseases; Pregnancy; Sleep; Substance-Related Disorders

Topics: Adult; Female; Heroin; Heroin Dependence; Humans; Infant, Newborn; Infant, Newborn, Diseases; Maternal-Fetal Exchange; Morphine; Morphine Dependence; Pregnancy; Pregnancy Complications; Substance-Related Disorders

Topics: Female; Fetus; Heroin; Heroin Dependence; Humans; Infant, Newborn; Infant, Newborn, Diseases; Labor, Obstetric; Methadone; Postpartum Period; 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

32 pregnancies in 29 drug-addicted women were studied ouver eight years in one obstetric department working in close liaison with a drug dependency centre. Of the 24 pregnancies which came to term, only 10 were seen at the antenatal clinic before 22 weeks' gestation. 19 of the women were addicted to heroin or methadone or a mixture of both, 4 were taking soft drugs, and 1 was taking pethidine only. Labour commenced spontaneously in 17 pregnancies and was induced in 7. All labours lasted less than twenty hours. 23 infants survived. Those born to the mother taking pethidine and to 4 mothers who withdrew their drug of dependence four weeks before delivery showed no signs of narcotic withdrawal, but 13 out of 14 infants born to mothers taking heroin or methadone developed narcotic withdrawal syndrome. It is recommended that drug therapy during pregnancy in addicts should be supervised by a psychiatrist known to the patient and that oral methadone be substituted for heroin. Planned induction will ensure delivery in hospital, at the hospital which has supervised the pregnancy. Babies in danger of developing narcotic withdrawal syndrome should be observed in the special care baby unit for the first week of life.

Topics: Adult; Female; Follow-Up Studies; Heroin; Heroin Dependence; Humans; Infant, Newborn; Infant, Newborn, Diseases; Labor, Obstetric; London; Methadone; Postpartum Period; Pregnancy; Pregnancy Complications; Substance Withdrawal Syndrome; Substance-Related Disorders; Time Factors

A case of a severe heroin withdrawal syndrom in a newborn infant is reported. Diagnostic and therapeutic aspects of the disease are reviewed.

Topics: Chloral Hydrate; Diazepam; Female; Heroin; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Newborn, Diseases; Maternal-Fetal Exchange; Muscle Tonus; Phenobarbital; Pregnancy; Seizures; Substance Withdrawal Syndrome

Immediate attention must be given to the respiratory system of the heroin abuser; then he should be given naloxone HCl. Search for evidence of use of additional drugs, which may compound problems. Pulmonary edema, aspiration pneumonia and pulmonary embolization are the most common complications. Infections, particularly endocarditis, and cardiac arrhythmia also occur with heroin overdose. Hepatitis is common. Treatment must include not only attention to the presenting symptoms but also referral to a rehabilitation center when possible.

Topics: Arrhythmias, Cardiac; Chemical and Drug Induced Liver Injury; Dose-Response Relationship, Drug; Emergency Service, Hospital; Endocarditis; Female; Genital Diseases, Female; Heroin; Heroin Dependence; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infections; Male; Methadone; Naloxone; Pulmonary Edema; Respiratory Insufficiency

The behavior of narcotics-addicted and nonaddicted newborns on the first 2 days of life was assessed with the Brazelton Neonatal Behavioral Assessment Scale. In addition to classic signs of narcotics abstinence, addicted infants were less able to be maintained in an alert state and less able to orient to auditory and visual stimuli. These deficits were especially pronounced at 48 hours of age. Addicted infants were as capable of self-quieting and responding to soothing intervention as normal neonates, although they were substantially more irritable. These characteristics and addicted infants' greater resistance to cuddling are discussed in terms of their potential impact on early infant-care-giver interaction.

Topics: Adult; Attention; Female; Habituation, Psychophysiologic; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Labor, Obstetric; Male; Maternal-Fetal Exchange; Methadone; Orientation; Pregnancy; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Apgar Score; Birth Weight; Breech Presentation; Chlorpromazine; Delivery, Obstetric; Female; Fetal Death; Hepatitis; Hernia, Inguinal; Heroin; Heroin Dependence; Humans; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Jaundice, Neonatal; Menstruation Disturbances; Pregnancy; Pregnancy Complications; Prenatal Care; Substance Withdrawal Syndrome; United States

Topics: Abnormalities, Drug-Induced; Adult; Age Factors; Barbiturates; Camphor; Chlorpromazine; Codeine; Diazepam; Female; Fetus; Heroin; Heroin Dependence; Humans; Infant, Newborn; Infant, Newborn, Diseases; Maternal Age; Methadone; Opium; Phenobarbital; Pregnancy; Pregnancy Complications; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Amphetamine; Antipsychotic Agents; Barbiturates; Cannabis; Child Welfare; Chlorpromazine; Diazepam; Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Lysergic Acid Diethylamide; Maternal-Fetal Exchange; Pregnancy; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Administration, Oral; Adult; Apgar Score; Birth Weight; Female; Fetal Death; Heroin; Heroin Dependence; Humans; Infant, Newborn; Infant, Newborn, Diseases; Maternal-Fetal Exchange; Methadone; New York City; Obstetric Labor, Premature; Parity; Pregnancy; Pregnancy Complications; Prognosis; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Adult; Birth Weight; Depression; Female; Fetal Diseases; Fetus; Heroin; Heroin Dependence; Humans; Hyperbilirubinemia; Infant, Newborn; Infant, Newborn, Diseases; Maternal-Fetal Exchange; Microsomes, Liver; Narcotics; Pregnancy; Respiratory Distress Syndrome, Newborn; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Alkalosis; Carbon Dioxide; Female; Heroin; Humans; Hyperventilation; Infant, Newborn; Infant, Newborn, Diseases; Morphine Dependence; Oxygen; Pregnancy; Pregnancy Complications; Substance-Related Disorders

Topics: Anticonvulsants; Apgar Score; Barbiturates; Epilepsy; Female; Gestational Age; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Maternal-Fetal Exchange; Phenobarbital; Pregnancy; Pregnancy Complications; Substance Withdrawal Syndrome; Substance-Related Disorders; Time Factors

Topics: Acid-Base Equilibrium; Alkalosis, Respiratory; Capillaries; Carbon Dioxide; Heroin; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Infant, Newborn, Diseases; Respiration; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Adolescent; Adult; Amniocentesis; Bilirubin; Birth Weight; Female; Gestational Age; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Methadone; Pregnancy; Pregnancy Complications; Prenatal Care; Psychotherapy, Group; Substance Withdrawal Syndrome; Substance-Related Disorders; Time Factors

Topics: Alkalosis; Alkalosis, Respiratory; Female; Heroin; Humans; Hyperventilation; Infant, Newborn; Infant, Newborn, Diseases; Pregnancy; Pregnancy Complications; Substance-Related Disorders

Topics: Female; Gestational Age; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Maternal-Fetal Exchange; Methadone; Pregnancy; Pregnancy Complications; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Administration, Oral; Adult; Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Methadone; Morphine Dependence; Pregnancy; Pregnancy Complications

Topics: Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Maternal-Fetal Exchange; Methadone; Morphine Dependence; Pregnancy; Substance Withdrawal Syndrome

Topics: Adolescent; Adult; Apgar Score; Birth Weight; Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Methadone; Neurologic Manifestations; Opium; Phenobarbital; Pregnancy; Pregnancy Complications; Substance Withdrawal Syndrome; Substance-Related Disorders; Vomiting

Topics: Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Maternal-Fetal Exchange; Michigan; Morphine Dependence; Pregnancy

Topics: Adult; Cholangitis; Cholecystitis; Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Methadone; Morphine Dependence; Pregnancy; Pregnancy Complications; Substance Withdrawal Syndrome

Topics: Chlorpromazine; Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Maternal-Fetal Exchange; Morphine Dependence; Phenobarbital; Pregnancy; Pregnancy Complications; Substance Withdrawal Syndrome

Topics: Barbiturates; Cannabis; Codeine; Female; Heroin; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Maternal-Fetal Exchange; Methamphetamine; Narcotics; Pregnancy; Pregnancy Complications; Substance-Related Disorders; Toxicology

Topics: Adrenal Cortex; Adrenal Cortex Diseases; Brain; Brain Diseases; Heroin; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestines

Topics: Heroin; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Opioid-Related Disorders; Substance-Related Disorders