ELEVATED PLASMA NOREPINEPHRINE AFTER IN-UTERO EXPOSURE TO COCAINE ANDMARIJUANA

Objective. To compare plasma catecholamine concentrations between coca ine-exposed and unexposed term newborns and to determine the relations hip between plasma catecholamines and newborn behavior. Methods. Forty -six newborn infants participating in a prospective study of the neona tal and long-term effects of prenatal cocaine exposure were studied. B ased on maternal self-report, maternal urine screening, and infant mec onium analysis, 24 infants were classified as cocaine-exposed and 22 a s unexposed. Between 24 and 72 hours postpartum, plasma samples for no repinephrine (NE), epinephrine, dopamine, and dihydroxyphenylalanine a nalysis were obtained. The Neonatal Behavioral Assessment Scale was ad ministered at 1 to 3 days of age and at 2 weeks of age by examiners ma sked to the drug exposure status of the newborns. Results. The cocaine -exposed newborns had increased plasma NE concentrations when compared to the unexposed infants (geometric mean, 923 pg/mL vs 667 pg/mL). Th ere were no significant differences in plasma epinephrine, dopamine, o r dihydroxyphenylalanine concentrations. Analysis for the effect of po tential confounding variables revealed that maternal marijuana use was also associated with increased plasma NE, although birth weight, gend er, and maternal use of alcohol or cigarettes were not. Geometric mean plasma NE was 1164 pg/mL in those infants with in utero exposure to b oth cocaine and marijuana compared to 812 pg/mL in those exposed to on ly cocaine and 667 pg/mL in those exposed to neither. Among the cocain e-exposed infants, plasma NE concentration correlated with an increase d score for the depressed cluster (r = .53) and a decreased score for the orientation cluster (r = -.43) of the Neonatal Behavioral Assessme nt Scale administered at 1 to 3 days of age. Adjusting for marijuana e xposure had no effect on these relationships between plasma NE and the depressed and orientation clusters. Conclusion. Plasma NE is increase d in newborns exposed to cocaine and marijuana. Increased plasma NE is associated with selected neurobehavioral disturbances among cocaine e xposed infants at 1 to 3 days of life but not at 2 weeks.