Clinical and economic effects of iNO in premature newborns with respiratory failure at 1 year.

Background: The long-term consequences of inhaled nitric oxide (iNO) use in premature newborns with respiratory failure are unknown. We therefore studied the clinical and economic outcomes to 1 year of corrected age after a randomized controlled trial of prophylactic iNO.

Methods: Premature newborns (gestational age View Article and Find Full Text PDF

Prenatal drug exposure and selective attention in preschoolers.

Deficits in sustained attention and impulsivity have previously been demonstrated in preschoolers prenatally exposed to cocaine. We assessed an additional component of attention, selective attention, in a large, poly-substance cocaine-exposed cohort of 4 year olds and their at-risk comparison group. Employing postpartum maternal report and biological assay, we assigned children to overlapping exposed and complementary control groups for maternal use of cocaine, alcohol, marijuana, and cigarettes.

Children prenatally exposed to cocaine: developmental outcomes and environmental risks at seven years of age.

Data are equivocal regarding the long-term consequences of prenatal exposure to cocaine on school-aged children. We compared 101 children exposed prenatally to cocaine with 130 unexposed children on measures of intelligence, visual motor, and motor abilities at age 7 years. Bivariate analyses revealed that cocaine-exposed children scored significantly lower than comparison children on the abbreviated Wechsler Intelligence Scale for Children-Third Edition Verbal and Full Scale IQ scores, the Visual Motor Integration and Motor Coordination standardized scores, and the Bruininks-Oseretsky Fine Motor Composite score.

Executive functioning in preschool-age children prenatally exposed to alcohol, cocaine, and marijuana.

Background: Reports from clinical and experimental (animal) research converge on the suggestion that prenatal exposure to alcohol, cocaine, or marijuana undermines executive functioning (EF) and its neurological underpinnings. However, large, adequately controlled, prospective studies of alcohol and marijuana effects on EF have reported conflicting findings, and there have been no such studies of cocaine exposure.

Methods: EF was investigated in a cohort (n = 316) of 4-year-old children the majority of whose mothers had used varying combinations of cocaine, alcohol, and marijuana during pregnancy.

Accuracy in Detecting Prenatal Drug Exposure.

A basic problem encountered by investigations of prenatal cocaine effects has been the valid identification and quantification of exposure. Based on a combination of sources: (a) medical record review, (b) maternal urine toxicology screen, (c) meconium analysis, and (d) maternal postpartum interview, drug exposure status of 415 infants was established. Using this combination as a benchmark, maternal postpartum interview was found most sensitive, while medical record review was slightly less accurate.

Medical and Psychologic Risks of Maternal Cocaine Use.

The growing use of crack-cocaine by women of child-bearing age poses significant management problems for physicians. Both animal and human studies suggest that cocaine exerts significant negative effects on maternal health, the course of pregnancy, and infant developmental outcome. Maternal pregnancy complications and increased rates of low birth weight and prematurity in infants who are fetally exposed are well documented.

Fetal Cocaine Exposure: Neurologic Effects and Sensory-Motor Delays.

Research on animal models demonstrates that fetal cocaine exposure results in neurologic deficits in memory and learning. Although drug effects on human infants are difficult to separate from other environmental influences of a drug-using lifestyle, studies suggest that infants exposed to cocaine in utero have reduced growth, delays in sensory-motor development, attentional deficits, and depressed responsivity to social stimulation. Standard interventions to promote behavioral state regulation in affected infants may be helpful when parents are capable of participating.