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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Follow-up of infants prenatally exposed to cocaine
Cassandra Schiller1, Pat Jackson Allen
1Yale University School of Nursing, New Haven, CT, USA.
Insights
Prenatal cocaine exposure can lead to subtle developmental and physiologic effects in infants. Primary care practitioners need guidelines to identify and manage these issues in the first three years of life.
Area of Science:
- Pediatrics
- Neonatal Health
- Developmental Psychology
Background:
- Maternal cocaine use during pregnancy is a significant public health concern.
- Research is expanding to understand the effects of prenatal cocaine exposure on infants and young children.
- Inconsistent findings exist regarding the precise physiologic and developmental outcomes.
Purpose of the Study:
- To critically review existing literature on prenatal cocaine exposure.
- To identify the primary care needs of exposed infants and young children.
- To provide guidelines for monitoring health sequelae in the first three years of life.
Main Methods:
- Literature review of studies on prenatal cocaine exposure.
- Analysis of reported physiologic and developmental outcomes.
- Identification of confounding variables, such as poly-drug use.
- Development of monitoring guidelines for primary care practitioners.
Main Results:
- Inconsistent findings in the literature regarding developmental and physiologic outcomes.
- Well-controlled studies report subtle effects requiring attention.
- Confounding variables like poly-drug use complicate outcome isolation.
- Need for early identification and intervention by healthcare providers.
Conclusions:
- Early identification and intervention are crucial for mitigating negative health outcomes.
- Guidelines are proposed to aid practitioners in assessing known effects.
- Further research is warranted to isolate cocaine's specific effects.
Abstract:
Maternal cocaine use during pregnancy continues to be of great concern for health care professionals. Research in this area has increased as investigators examine the effects of prenatal cocaine exposure in the infant/young child. This paper will critically review the literature, identify the primary care needs of infants and young children with a known history of prenatal cocaine exposure, and present guidelines for the primary care practitioner to monitor the infant's physiologic and developmental sequelae during the first 3 years of life. Findings in the literature demonstrate inconsistencies in regard to the physiologic and developmental outcomes of infants/young children prenatally exposed to cocaine. Further research is warranted, as it is evident from studies that not all investigators are controlling for confounding variables such as poly-drug use, which is necessary in isolating cocaine's effects. Subtle effects, however, have been reported from well-controlled studies and, thus, particular attention needs to be paid to early identification and interventions by primary care practitioners to prevent negative health outcomes. The guidelines proposed assist the practitioner with a thorough and focused approach to assessing the physiologic and developmental effects that are currently known to occur in the infant/young child prenatally exposed to cocaine.
