Elsevier

Pediatric Neurology

Volume 9, Issue 2, March–April 1993, Pages 115-119
Pediatric Neurology

Original article
Neurologic findings in neonates with intrauterine cocaine exposure

https://doi.org/10.1016/0887-8994(93)90045-EGet rights and content

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.

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      Cocaine exposure during the fetal period can lead to lasting impairment of neurological function (Chasnoff et al., 1989a,b; Chiriboga et al., 1993, 2009; Delaney-Black et al., 1996; Eyler et al., 2009; Kosofsky and Wilkins, 1998).

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    This study was supported in part by a grant from the National Institutes of Health (5T32NB07153 and K08-NS01528).

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