Sequential neuromotor examination in children with intrauterine cocaine polydrug exposure

Citation
Hme. Belcher et al., Sequential neuromotor examination in children with intrauterine cocaine polydrug exposure, DEVELOP MED, 41(4), 1999, pp. 240-246
Citations number
48
Categorie Soggetti
Pediatrics,"Neurosciences & Behavoir
Journal title
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY
ISSN journal
00121622 → ACNP
Volume
41
Issue
4
Year of publication
1999
Pages
240 - 246
Database
ISI
SICI code
0012-1622(199904)41:4<240:SNEICW>2.0.ZU;2-V
Abstract
Data are presented on 157 newborn infants followed sequentially in a random ized home-based nursing-intervention trial for drug-exposed infants with fo llow up at 3 (N=118), 6 (N=124), and 12 months (N=77). The objectives of th is study were to describe the longitudinal neurodevelopmental status of a c ohort of children with intrauterine exposure to illicit drugs during their gestation, characterize the evolution of early tone abnormalities in a poly drug-exposed cohort, and determine whether neuromotor outcome is associated with drug-exposure patterns. For analysis, infants were grouped based on m aternal drug-use pattern and the presence of drug metabolites in the neonat al drug screen. The sequential neuromotor examination was used at each age to define the neuromotor status of six domains and define categorical class ifications as either normal, suspect, or abnormal. Multiple patterns of neu romotor abnormalities were observed during the neonatal period; most resolv ed over time. Axial hypotonia was a prominent finding in the neonatal perio d; however, it was infrequent in abnormal examinations at 12 months. Increa sed lower-extremity tone was a less frequent finding during the neonatal pe riod. Infants whose neonatal urine drug screen was positive for both cocain e and opiates, were more likely than infants with negative urine drug scree ns, cocaine only, or opiate only drug screen results to have abnormal neuro motor examinations; while positive maternal drug screens for concurrent coc aine and opiate use were associated with peripheral hypertonia. Persistence of increased leg-extensor tone was found in 67% of the abnormal examinatio ns at 12 months. Acquisition of rolling and walking was delayed in the drug -exposed cohort.