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Patterns of growth and development in narcotic-exposed children
1Baylor College of Medicine, Meyer Center for Developmental Pediatrics, Houston, TX 77054.
Insights
Drug use during pregnancy negatively impacts intrauterine growth. Long-term effects on offspring development, including behavioral and learning issues, are suggested but require further research.
Area of Science:
- Obstetrics and Gynecology
- Neonatalogy
- Developmental Pediatrics
Background:
- Intrauterine growth can be negatively impacted by maternal drug use during pregnancy.
- The precise mechanisms, whether direct drug effects or confounding lifestyle factors, remain unclear.
- Existing research presents inconsistent findings on the long-term developmental outcomes for affected offspring.
Purpose of the Study:
- To review and synthesize current evidence on the effects of drug use during pregnancy on fetal growth and long-term child development.
- To explore potential direct teratogenic effects versus indirect influences of maternal lifestyle.
- To identify gaps in knowledge regarding neurobehavioral and intellectual outcomes.
Main Methods:
- Systematic review of existing studies on maternal drug use and offspring development.
- Analysis of data concerning intrauterine growth, catch-up growth, and long-term developmental trajectories.
- Evaluation of studies reporting on behavioral and intellectual functioning in children exposed to drugs in utero.
Main Results:
- Maternal drug use is associated with adverse effects on intrauterine growth.
- Long-term outcomes are inconsistent; some studies show catch-up growth, while others suggest direct teratogenic effects like reduced head size.
- Narcotic-exposed children exhibit a high incidence of behavioral and learning problems, potentially indicating a biological vulnerability.
Conclusions:
- Drug use during pregnancy poses risks to fetal development and offspring neurobehavioral outcomes.
- Further research with larger, methodologically sound studies is needed to clarify direct effects and long-term consequences.
- Maternal drug abuse may create a biological vulnerability in offspring, exacerbating the impact of adverse environments.
Abstract:
The results of the studies reviewed indicate that intrauterine growth is adversely affected by drug use during pregnancy. Whether the impairment is a direct effect of narcotic exposure or is the result of the interaction of deleterious health, environmental, and socioeconomic factors closely associated with the lifestyle of the woman who abuses drugs cannot be determined at present. Reports on the long-term effects of drug use on growth and intellectual functioning in the offspring of women who abuse drugs are not consistent. While some studies indicate that most of the exposed infants exhibit catchup growth by 6 months of age (Lifschitz et al. 1983, 1985), one methodologically strong study suggests that methadone may have a small direct teratogenic effect reflected in reduced head size at 2 years of age (Hans 1989). Unexplained is the pattern of growth deceleration observed in some narcotic-exposed children (Lifschitz et al. 1983, 1985). The few available reports on long-term outcome concur that narcotic-exposed children have a high incidence of behavioral and learning problems (Strauss et al. 1979; Rosen and Johnson 1985; Wilson 1989), but population studies have been too small to demonstrate that they differ significantly from controls. There is a suggestion that narcotic use during pregnancy promotes a biological vulnerability to adverse environments, manifested in the neurobehavioral and intellectual areas.