産前コカイン暴露後の幼児期の成長,発達,および行動: 体系的なレビュー
D A Frank1, M Augustyn, W G Knight
1Boston University School of Medicine, Boston, MA 02118-2393, USA. dafrank@bu.edu
JAMA
|April 13, 2001
まとめ
6歳までの子供の出生前コカイン暴露は,独特の発達障害の説得力のある証拠を示していません. タバコや環境などの他の要因も重要な役割を果たしています.
科学分野:
- 発達心理学の心理学について
- 神経科学は神経科学である.
- 公衆衛生は公衆衛生である.
背景:
- 公衆の認識と政策は,しばしば胎児前でのコカイン暴露を独特に有害なものとして見ています.
- 最近の研究では,子宮内でのコカイン暴露による壊滅的な影響の概念に異議を唱えている.
研究 の 目的:
- 産前コカイン暴露後の幼少期のアウトカムを批判的に見直す.
- 身体的成長,認知,言語,運動能力,行動/注意力における影響を検証する.
主な方法:
- MEDLINEとPsychological Abstracts (1984-2000) の体系的な文献検索を行った.
- 比較グループと前向きな仮面評価を備えた,ピアレビューされた英語研究の含有.
- オピエイト,アンフェタミン,フェンシクリジン,またはHIVに有意な共同被曝を伴う研究を除外.
主要な成果:
- 産前コカインの暴露と身体的成長,認知スコア,または言語能力との間に一貫した否定的な関連は見つかりませんでした.
- 7ヶ月まで観察された運動能力の欠乏は,たばこへの曝露と潜在的に関連している.
- 標準化された行動報告にコカインによる独立した影響はありません. 予備的な調査結果は,注意力や感情的表現力への影響を示唆しています.
結論:
- 妊娠前のコカインの曝露が6歳までの子供の独特の発達有毒性を引き起こすことを示す説得力のある証拠はありません.
- 観察された影響は,たばこ,マリファナ,アルコールの露出,環境の質などの他の危険因子としばしば相関しています.
- 予備的な神経学的発見を複製するためにさらなる研究が必要である.
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