RESUMO
OBJECTIVE: To identify neurobehavioral effects of prenatal marijuana exposure on neonates in rural Jamaica. DESIGN: Ethnographic field studies and standardized neuro-behavior assessments during the neonatal period. SETTING: Rural Jamaica in heavy-marijuana-using population. PARTICIPANTS: Twenty-four Jamaican neonates exposed to marijuana prenatally and 20 nonexposed neonates. MEASUREMENTS AND MAIN RESULTS: Exposed and nonexposed neonates were compared at 3 days and 1 month old, using the Brazelton Neonatal Assessment Scale, including supplementary items to capture possible subtle effects. There were no significant differences between exposed and nonexposed neonates on day 3. At 1 month, the exposed neonates showed better physiological stability and required less examiner facilitation to reach organized states. The neonates of heavy-marijuana-using mothers had better scores on autonomic stability, quality of alertness, irritability, and self-regulation and were judged to be more rewarding for caregivers. CONCLUSIONS: The absence of any differences between the exposed on nonexposed groups in the early neonatal period suggest that the better scores of exposed neonates at 1 month are traceable to the cultural positioning and social and economic characteristics of mothers using marijuana that select for the use of marijuana but also promote neonatal development.
Assuntos
Cannabis , Comportamento Infantil/efeitos dos fármacos , Recém-Nascido , Efeitos Tardios da Exposição Pré-Natal , Adolescente , Adulto , Antropologia Cultural , Estudos de Casos e Controles , Características Culturais , Feminino , Humanos , Jamaica , Fumar Maconha/etnologia , Gravidez , Fatores SocioeconômicosRESUMO
PIP: Triangulation is the use of multiple concepts and methods to study a single phenomenon. Ethnographic field studies and standardized measures of development were used in a study of long-term effects of perinatal cannabis (marijuana) use in Jamaica. The study was launched in 1983 in order to evaluate the effects of cannabis (or ganja, as it is called in Jamaica) consumption during pregnancy and lactation on infants from birth to school age in rural communities. Some researchers reported symptoms such as increased startles, high-pitched cry in the newborn, shortened gestation, and low birth weight. The project was based in St. Thomas, where ganja use is widespread. The ethnographic part involved home observations and interviews of each child in selected communities. The clinical component included monitoring 60 pregnant women (30 users and 30 nonusers) and their offspring from birth through age 5. The instruments for evaluation included the Brazelton Neonatal Assessment Scale (BNAS), the Bayley Scales of Infant Development (BSID), the McCarthy Scales of Children's Abilities (MSCA, for children aged 2 years 6 months to 8 years 6 months), and the Behavioral Style Questionnaire (BSQ, for temperament in 3 to 7 year olds). The MSCA and BSQ had to be adapted to local culture, partly because of different uses of words in the rural dialect and cultural experience. The MSCA modifications included the elimination of time limits, changes in language, and culturally correct alternative responses. Five of 72 items on the BSQ were modified. Most scores fell in the middle range of about 4, similar to the North American scores, except for the lower mean in the category of Threshold of Responsiveness, because of an unanticipated cultural difference. The adjustments made did not compromise the comparability of the findings.^ieng
Assuntos
Deficiências do Desenvolvimento/epidemiologia , Fumar Maconha/efeitos adversos , Pesquisa Metodológica em Enfermagem/métodos , Complicações na Gravidez , Pré-Escolar , Barreiras de Comunicação , Comparação Transcultural , Deficiências do Desenvolvimento/etiologia , Deficiências do Desenvolvimento/enfermagem , Feminino , Humanos , Lactente , Jamaica/epidemiologia , Fumar Maconha/etnologia , América do Norte , Avaliação em Enfermagem/normas , Pesquisa Metodológica em Enfermagem/normas , Gravidez , População Rural , Inquéritos e Questionários/normas , Enfermagem Transcultural/normasRESUMO
This research provides data on the development of 59 Jamaican children, from birth to age 5 years, whose mothers used marijuana during pregnancy. Approximately one-half of the sample used marijuana during pregnancy and were matched with non-users according to age, parity, and socioeconomic status. Testing of the children was done at 1, 3, and 30 days of age with the Brazelton Neonatal Behavioral Assessment Scales and at ages 4 and 5 years with the McCarthy Scales of Children's Abilities. Data about the child's home environment and temperament were collected from direct observations as well as from standardized questionnaires. The results show no significant differences in developmental testing outcomes between children of marijuana-using and non-using mothers except at 30 days of age when the babies of users had more favourable scores on two clusters of the Brazelton Scales: autonomic stability and reflexes. The developmental scores at ages 4 and 5 years were significantly correlated to certain aspects of the home environment and to regularity of basic school (preschool) attendance.
Assuntos
Desenvolvimento Infantil , Fumar Maconha , Efeitos Tardios da Exposição Pré-Natal , Adulto , Pré-Escolar , Feminino , Seguimentos , Humanos , Recém-Nascido , Jamaica , Gravidez , População Rural , Fatores SocioeconômicosRESUMO
This research provides data on the development of 59 Jamaican children, from birth to age 5 years, whose mothers used marijuana during pregnancy. Approximately one-half of the sample used marijuana during pregnancy and were matched with non-users according to age, parity, and socioeconomic status. Testing of the children was done at 1, 3, and 30 days of age with the Brazelton Neonatal Behavioral Assessment Scales and at ages 3 and 5 years with the McCarthy Scales of Children's Abilities. Data about the child's home environment and temperament were collected from direct observations as well as from standardized questionnaires. The results show no significant differences in developmental testing outcomes between children of marijuana-using and non-using mothers except at 30 days of age when the babies of users had more favourable scores on two clusters of the Brazelton Scales: autonomic stability and reflexes. The developmental scores at ages 4 and 5 were significantly correlated to certain aspects of the home environment and to regularity of basic school (preschool) attendance.
Assuntos
Humanos , Recém-Nascido , Pré-Escolar , Feminino , Gravidez , Deficiências do Desenvolvimento/etiologia , Abuso de Maconha , Fatores Socioeconômicos , Resultado da Gravidez , Desenvolvimento Infantil , Seguimentos , JamaicaRESUMO
This paper reports the ethnographic findings from a study of cannabis use by pregnant women in rural Jamaica. The perceived functions of ganja in reducing the physiological symptoms of pregnancy and associated psychological stress are described in relation to the sociocultural context of pregnancy in low-income rural communities. The data suggest that distinguishing life-style characteristics of cannabis-smoking women may actually mitigate the potentially harmful effects of marihuana.