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Physiatric management of two neonates with limb deficiencies and prenatal cocaine exposure
1Division of Physical Medicine and Rehabilitation, Long Island Jewish Medical Center, New Hyde Park, NY 11042.
Insights
Maternal cocaine use during pregnancy may increase the risk of limb malformations in newborns. This report highlights two cases of neonates with limb deficits and positive toxicology screens for cocaine metabolites.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Toxicology
Background:
- Maternal substance use during pregnancy is a significant concern.
- Cocaine exposure in utero has been linked to various adverse outcomes.
- Limb malformations represent a critical developmental issue.
Observation:
- Two neonates born within nine weeks presented with limb malformations.
- Urine toxicology screenings were positive for cocaine metabolites and other drugs in both neonates.
- Literature suggests a correlation between fetal cocaine exposure and limb reduction deficits.
Findings:
- The observed cases support the hypothesis that maternal cocaine use can lead to limb malformations.
- Detailed case studies illustrate the presentation and potential etiology.
- Physiatric management strategies for affected neonates were explored.
Implications:
- Physiatrists should be aware of a potential increase in limb malformations associated with maternal cocaine use.
- Early identification and intervention are crucial for managing these congenital anomalies.
- This underscores the importance of prenatal care and substance abuse screening.
Abstract:
We evaluated two neonates born within nine weeks of each other who had limb malformations and whose urine toxicology screenings were positive for cocaine metabolites and other drugs. Review of the literature indicates that fetal exposure to cocaine could lead to limb reduction deficits. The purpose of this report is to alert the physiatrist to a possible increase in incidence of limb malformation related to maternal cocaine use during pregnancy. The two cases are detailed, etiology is discussed, and the initial physiatric management is explained.