Jörg Reichert

Methamphetamine Consumption during Pregnancy – Effects on Child Health

Methamphetamine abuse during pregnancy represents an emerging health care problem. The consequences are not only of relevance to the pregnant women, but also their unborn child. It is associated with an increased risk of preeclampsia and hypertension, fetal demise, preterm delivery, and intrauterine growth restriction. The deleterious effects of prenatal methamphetamine exposure on the developing fetal brain may lead to long-term neuro-developmental and behavioral problems.Given the current evidence, abuse of methamphetamine during pregnancy must be of utmost concern to health care professionals and to policy-makers. As it has been described for neonatal abstinence syndrome, a multi-professional team is required to improve care of affected women and families. A multi-disciplinary approach is needed, including good prenatal care of pregnant women, perinatal care by specialized obstetricians and neonatologists, and psychiatric treatment by an addiction specialist. Furthermore, families should be integrated into appropriate social support networks.For the development of a structured support program for pregnant women with methamphetamine consumption, methamphetamine use disorder should be considered as a disease that requires medical treatment as well as psychological and social support. The pregnancy should be considered as a window of opportunity to provide the required help.

Adolescents Admitted to In-Patient Treatment with Alcohol Intoxication:Risk and Resilience Factors Associated with Problematic Alcohol Use

Background and Objectives: Although the number of adolescents admitted to in-patient treatment with alcohol intoxication (AIA) has strongly risen in many countries, knowledge about this patient population with respect to risk and resilience factors is lacking. The objectives of this study were (1) to explore whether the prevalence of substance use and use-related problems in a sample of AIA is elevated compared to adolescents from the general population and (2) to investigate which biopsychosocial factors are associated with prior problematic alcohol use in AIA. Methods: In a cross-sectional naturalistic study 65 AIA (M and SD age 15.2 ± 1.6 yr) completed questionnaires and were interviewed the morning after admission in two pediatric hospitals in the City of Dresden, Germany. Assessment included substance use, alcohol use disorders, and risk and resilience factors for problematic alcohol use. Results: Elevated prevalence rates were found for alcohol abuse, alcohol dependence, binge drinking, smoking, and illicit substance use. Exploratory analyses revealed that deviant peer affiliations, a positive family history of alcoholism, an elevated alcohol tolerance, and a parenting style characterized by less supervision and strictness were associated with problematic alcohol use. Conclusions: The investigated risk and resilience factors for problematic alcohol use should be included in the clinical decision regarding psychosocial interventions following hospitalization.

Which information will be given to parents of preterm infants--a comparison of estimates and local data.

Abstract Objective: Parents of preterm infants require information on morbidity and duration of common interventions performed in the NICU. Since locally achieved data are often not available, information is mainly based on educated guesses of health care professionals. The present study compares estimates of neonatal nurses or medical doctors (MDs) in two separate NICUs with local data. Methods: Health care professionals were asked to estimate morbidity and duration of medical interventions of two groups of very low birth weight infants. For comparison, local data were obtained from infant charts and the Vermont Oxford Neonatal Network data base. Results: Incidence of BPD was underestimated by MDs and overestimated by nurses for low birth weight group (500–750 g) and overestimated by nurses for 1250– 1500 g infants. Incidence of IVH was significantly overestimated by nurses for both groups. Duration of ventilatory support was underestimated for infants of a gestational age of 24–27 weeks and overestimated for the age group of 31–32 weeks. Length of stay in NICU was underestimated for infants at gestational age of 24–27 weeks, but not for the 32–33 weeks group. Conclusions: Information based on estimates made by health care professionals may be misleading. Data differ significantly among different NICUs, thus, local data should be obtained by each NICU and used to inform parents appropriately.