RESUMO
To evaluate the possible effects of maternal intravenous drug use on infant immunity, we measured the in vitro peripheral blood mononuclear cell proliferative responses to phytohemagglutinin (PHA) and pokeweed mitogen, T cell subset numbers, immunoglobulin levels, and titers of antibodies to cytomegalovirus (CMV) and human immunodeficiency virus (HIV) in a group of drug-abusing mothers and their infants. Infants of drug abusers had a lower proliferative response to mitogen, associated with altered kinetics of the maximum response to PHA. The OKT4/OKT8 ratio decreased with age in the drug-exposed infants compared with control infants (P less than 0.005). There was no evidence of CMV infection in either group. One mother and her infant had antibody to HIV. Our data demonstrate that infants of intravenous drug-using mothers have distinct immunologic differences at birth compared with non-drug-exposed infants and that these persist throughout the first year of life. The cause appears unrelated to intrauterine viral infection, suggesting a direct toxic effect of the drugs on fetal immunologic development.
Assuntos
Linfócitos/imunologia , Efeitos Tardios da Exposição Pré-Natal , Transtornos Relacionados ao Uso de Substâncias/complicações , Anticorpos Antivirais/análise , Citomegalovirus/imunologia , Feminino , HIV/imunologia , Humanos , Lactente , Recém-Nascido , Contagem de Leucócitos , Ativação Linfocitária/efeitos dos fármacos , Linfócitos/efeitos dos fármacos , Fenótipo , Fito-Hemaglutininas/farmacologia , Mitógenos de Phytolacca americana/farmacologia , Gravidez , Transtornos Relacionados ao Uso de Substâncias/imunologia , Linfócitos T/classificação , Fatores de TempoRESUMO
Intracranial hemorrhage and posthemorrhagic ventricular dilation are common problems in small preterm infants. To determine the optimal timing for ultrasound diagnosis of these abnormalities, we studied 64 preterm infants (less than 1,500 gm) by sequential cranial ultrasonography from birth until one year of age or until death. The optimal timing for ultrasound diagnosis of intracranial hemorrhage is days 4 to 7 with follow-up at day 14. The most efficient time for ultrasound examination to diagnose ventricular dilation was day 14 with follow-up at 3 months. Intracranial hemorrhage was diagnosed by ultrasound in 35 of the 64 patients (55%). In 18 of the 64 infants (28%) significant ventricular dilation was diagnosed by ultrasound during the first three months.