PRENATAL COCAINE EXPOSURE ALTERS POSTNATAL HYPOXIC AROUSAL RESPONSES AND HYPERCARBIC VENTILATORY RESPONSES BUT NOT PNEUMOCARDIOGRAMS IN PRENATALLY COCAINE-EXPOSED TERM INFANTS

To test the hypothesis that respiratory control is altered in cocaine- exposed infants, we evaluated the hypoxic arousal response and the ven tilatory response to carbon dioxide (CO2) in 18 term newborn infants p renatally exposed to cocaine and in 10 healthy, term newborn infants w ithin the first week of life. Three infants could not be tested for th e hypoxic arousal response because of low baseline oxygen saturation, and data from these infants were excluded from analysis. Twelve hour o vernight pneumocardiograms were performed on all infants. Results show that 60% (9/15) of the prenatally cocaine-exposed infants had an abno rmal hypoxic arousal response and 87% (13/15) had abnormal hypercarbic ventilatory response. Only 6% (1/15) of the prenatally cocaine-expose d infants demonstrated any abnormality on pneumocardiogram. In contras t, all control infants (10/10) were aroused by the hypoxic challenge a nd 80% (8/10) had normal ventilatory response to CO2. No abnormalities were found in the assessment of the overnight pneumocardiogram in the control infants. For the cocaine-exposed infants, test abnormalities were not correlated with a concurrent positive urine toxicology for co caine, suggesting that the injury occurs early in development. These f indings support the hypothesis that infants prenatally exposed to coca ine demonstrate abnormalities of respiratory control. (C) 1994 Wiley-L iss, Inc.