RESUMEN
We studied the effect of heroin and methadone on birth length and 3-year stature of children of untreated heroin addicts (n = 22), women receiving methadone maintenance therapy (95% were polydrug users) (n = 21), and a drug-free comparison group (n = 28), after adjustment for biologic, demographic, and health variables. The mean birth lengths of both groups of drug-exposed infants were significantly below that of a comparison group; however, group means were similar after adjustment for sex, race, prenatal care, pregnancy weight gain, obstetrical risk, maternal education, and smoking. At 3 years of age the mean height was comparable for all groups. When adjusted for birth length, parental height, and smoking, the methadone group was significantly shorter than children exposed to heroin in utero, and the comparison group assumed an intermediate position. These data indicate that the effect of heroin and methadone on intrauterine growth cannot be differentiated from that of associated factors, and that postnatal growth of children exposed to narcotics during pregnancy is no more impaired than that of a high-risk comparison group. Children of all three groups deserve continued observation and efforts to improve their environment in order that their full potential might be achieved.
Asunto(s)
Feto/fisiología , Crecimiento , Dependencia de Heroína/complicaciones , Metadona , Trastornos Relacionados con Opioides/complicaciones , Complicaciones del Embarazo , Efectos Tardíos de la Exposición Prenatal , Estatura , Femenino , Humanos , Recién Nacido , Estudios Longitudinales , Masculino , Embarazo , Estudios ProspectivosRESUMEN
This study compares the first year's health, neurodevelopmental status, and environment of infants of drug-dependent mothers attending methadone programs during pregnancy with those of drug-dependent mothers not enrolled in treatment programs (untreated). Both groups were also compared with drug-free controls. During pregnancy, the use of heroin and other psychoactive drugs was common among patients using methadone. Neonatal abstinence syndrome was of longest duration in the methadone group. Infants of both drug groups were smaller at birth, had more neonatal infections, and were viewed as more difficult to care for after nursery discharge than were those of drug-free mothers. On follow-up, mean developmental scores were within the normal range for all groups. The untreated drug-dependent group was more hypertonic than the methadone group, and a high rate of transient or minor motor disturbances and poor attention span was found in both drug groups. The behavior of methadone-treated women during pregnancy and the postnatal period closely resembled that of drug-free controls, and contrasted with untreated drug-dependent women. Methadone-treated women had a high degree of compliance with antepartum care, and 80% continued in the role of parent through the first year. Further investigation will determine whether the consistency of parenting will continue and whether it will enhance the development of their children.