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Prenatal substance abuse

S L Ward1, T G Keens

  • 1Department of Pediatrics, University of Southern California School of Medicine, Los Angeles.

Clinics in Perinatology
|December 1, 1992
PubMed

Insights

Infants of mothers who used substances during pregnancy (ISAM) have higher SIDS risks. Home monitoring is only recommended for ISAM with clinical apnea, not all infants exposed to substances.

Area of Science:

  • Neonatal physiology
  • Pediatric critical care
  • Maternal-fetal medicine

Background:

  • Infants of substance-using mothers (ISAM) exhibit increased risks for Sudden Infant Death Syndrome (SIDS).
  • Cardiorespiratory physiology abnormalities are noted in ISAM, potentially contributing to SIDS risk.
  • Home monitoring is frequently employed for ISAM experiencing clinical apneic episodes.

Purpose of the Study:

  • To evaluate the necessity of home monitoring for all ISAM.
  • To differentiate SIDS risk factors in ISAM from direct effects of gestational drug exposure.
  • To establish clear guidelines for home monitoring in ISAM.

Main Methods:

  • Review of existing literature on ISAM, SIDS, and cardiorespiratory control.
  • Analysis of risk factors associated with SIDS in the ISAM population.
  • Clinical assessment of respiratory control abnormalities in ISAM.

Main Results:

  • The elevated SIDS risk in ISAM may be attributed to a concentration of risk factors within this population.
  • Gestational drug exposure alone is not definitively linked to causing SIDS.
  • Not all ISAM require home monitoring; indications are based on clinical presentation.

Conclusions:

  • Home monitoring is not universally indicated for all ISAM.
  • Monitoring should be reserved for ISAM presenting with apnea or other clinical signs of respiratory control abnormalities.
  • Further research may clarify the specific mechanisms linking ISAM to SIDS risk.

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