Neurologic findings in neonates with intrauterine cocaine exposure

Pediatr Neurol. 1993 Mar-Apr;9(2):115-9. doi: 10.1016/0887-8994(93)90045-e.

Abstract

To determine the effects of prenatal cocaine exposure on intrauterine growth and neurologic function, 30 term infants were evaluated prospectively: 14 cocaine-exposed and 16 unexposed. Cocaine-exposed infants had significantly lower mean birth weights, birth lengths, and head circumferences than urine-negative controls. Neurologic abnormalities among cocaine-exposed newborns included hypertonia of any type (86% vs 33%), axial hypertonia (79% vs 19%), plantar extension (46% vs 19%), and coarse tremor (57% vs 12%). The degree of hypertonia was sufficiently severe to warrant a diagnosis of "hypertonic tetraparesis" in 64% of cocaine-exposed and 12% of unexposed infants (P = .007). This diagnosis was highly correlated to small head size (r = 0.48; P = .01). Persistent tonic downward gaze was evident in two neurologically abnormal cocaine-exposed newborns. Gaze abnormalities improved slightly over the next 3 weeks of observation. One such infant re-evaluated at 6 months of age revealed resolution of tonic downward gaze and neurologic findings. We conclude that prenatal cocaine exposure is associated with tone and movement abnormalities in newborn infants.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Cephalometry
  • Cocaine / adverse effects*
  • Female
  • Fetal Growth Retardation / chemically induced
  • Fetal Growth Retardation / diagnosis
  • Humans
  • Infant, Newborn
  • Male
  • Muscle Hypertonia / chemically induced
  • Muscle Hypertonia / diagnosis
  • Neonatal Abstinence Syndrome / diagnosis*
  • Nervous System Diseases / chemically induced*
  • Nervous System Diseases / diagnosis
  • Neurologic Examination / drug effects*
  • Neuromuscular Diseases / chemically induced
  • Neuromuscular Diseases / diagnosis
  • Ocular Motility Disorders / chemically induced
  • Ocular Motility Disorders / diagnosis
  • Pregnancy
  • Pyramidal Tracts / drug effects
  • Quadriplegia / chemically induced
  • Quadriplegia / diagnosis
  • Reflex, Abnormal / drug effects

Substances

  • Cocaine