Prenatal drug exposure

A more pharmacologically oriented monograph "Prenatal Drug Exposure Kinetics and Dynamics, by Chiang and Lee (ref. 8) complements the coverage in the references 6 and 7 ... 

C. N. Chiang and C.C. Lee, (Eds.), Prenatal Drug Exposure Kinetics and Dynamics, NIDA Research Monograph 60, National Institute on Drug Abuse, Rockville, Maryland, 1985, 153 PP. 

Bauer CR. Perinatal effects of prenatal drug exposure. Neonatal aspects. Clin Perinatal 1999 26(1) 87-106. 

Ostrea, E. M. and Welch, R. A., Detection of prenatal drug exposure in the pregnant woman and her newborn infant, Clin. Perinatal., 18, 629, 1991. 

Wagner CL, Katikaneni LD, Cox TH, and Ryan RM (1998) The impact of prenatal drug exposure on the neonate. Obstetrics and Gynecology Clinics of North America 25(1) 169-194. 

V. Neonates present specific problems, including unique pharmacokinetics and potentially severe withdrawal from prenatal drug exposure. 

In the second study volumetric MRI data of brains were collected in 35 children, mean age 12 years, with intrauterine exposure to cocaine, alcohol, tobacco, and marijuana (14 cocaine-exposed and 21 noncocaine-exposed) [37 ]. The children with cocaine exposure had lower mean cortical gray matter, total parenchymal volumes, and smaller mean head circumference. As the number of exposures to prenatal substances grew, these specific measured areas showed further reductions in size. Even though the sample size was small, this study has provided relevant information on the adverse effect of prenatal drug exposure among older children. 

In a third study the Robert Wood Johnson database of published literature on prenatal cocaine exposure and child outcome was examined (274). Only 8 of 101 studies focused on school-age children. Intelligence quotient (IQ), receptive language, and expressive language were measured. This meta-analysis showed an average difference of 3.12 IQ points between cocaine-exposed and control groups. When the IQ distribution is shifted downwards by this amount, there is a 1.6-fold increase in the number of children with IQs under 70. The authors noted that the calculated decrement in IQ in exposed children is subtle and does not include the possible effect of the drug on domains of function such as language abilities. 

The behavioral effects of prenatal cocaine exposure at age 5 years have been studied in 140 children exposed to cocaine, 61 exposed to alcohol, tobacco, and/or marijuana, and 120 not exposed to any drugs (290). They were evaluated with the Achenbach Child Behavior Checklist. There was no association between behavior and intrauterine cocaine exposure. However, the current behavioral health of the mother, including recent drug use and psychological functioning, did affect the child s internalizing and externalizing behavior. 

Wasserman GA, Kline JK, Bateman DA, Chiriboga C, Lumey LH, Friedlander H, Melton L, Heagarty MC. Prenatal cocaine exposure and school-age intelligence. Drug Alcohol Depend 1998 50(3) 203-10. 

Smith L, Yonikura ML, Wallace T, Berman N, Kuo J, Berkowitz C. Effects of prenatal methamphetamine exposure on fetal growth and drug withdrawal symptoms in infants born at term. Dev Beh Pediatrics 2003 24 17-23. 

Eccles, C.U., and Z. Annau. 1982b. Prenatal methylmercury exposure II. Alterations in learning and psychotropic drug sensitivity in adult offspring. Neurobehav. Toxicol. Teratol. 4 (3) 377-382. 

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