Nancy L. Golden

Neonatal manifestations of maternal phencyclidine exposure

The purpose of this study was to determine the effects of maternal phencyclidine use on the fetus. Ninety-four neonates with maternal phencyclidine exposure were compared with 94 controls. Maternal phencyclidine use was assessed by questionnaire and repeated urine testing. Mothers of study and control patients were matched for demographic characteristics. Infants were assessed between 24-72 hours postnatally by a single examiner blind to the maternal history. The results showed that study infants had a mean of 5.02 +/- 2.93 abnormalities while controls had a mean of 4.13 +/- 2.65 abnormalities (p less than 0.01). Furthermore, study infants were more likely than controls to have poor attention, hypertonia, and depressed neonatal reflexes (p less than 0.05). The contribution of seven drug classes to the total number of abnormalities was assessed using stepwise multiple regression. Only phencyclidine accounted for a significant proportion of the variance (f = 4.38; p less than 0.05). The results of this study suggest that maternal phencyclidine use may lead to abnormal neonatal neurologic findings and behavior.The purpose of this study was to determine the effects of maternal phencyclidine use on the fetus. Ninety-four neonates with maternal phencyclidine exposure were compared with 94 controls. Maternal phencyclidine use was assessed by questionnaire and repeated urine testing. Mothers of study and control patients were matched for demographic characteristics. Infants were assessed between 24-72 hours postnatally by a single examiner blind to the maternal history. The results showed that study infants had a mean of 5.02 +/- 2.93 abnormalities while controls had a mean of 4.13 +/- 2.65 abnormalities (p less than 0.01). Furthermore, study infants were more likely than controls to have poor attention, hypertonia, and depressed neonatal reflexes (p less than 0.05). The contribution of seven drug classes to the total number of abnormalities was assessed using stepwise multiple regression. Only phencyclidine accounted for a significant proportion of the variance (f = 4.38; p less than 0.05). The results of this study suggest that maternal phencyclidine use may lead to abnormal neonatal neurologic findings and behavior.

Phencyclidine use during pregnancy

Phencyclidine, a frequently abused drug, has been shown to cross the placenta and may cause harmful effects in the fetus. Therefore, a prospective study was undertaken to determine the extent of phencyclidine use during pregnancy. Two thousand three hundred twenty-seven pregnant women were screened for phencyclidine use by questionnaire and enzyme-mediated immunoassay technique urine testing. Nineteen women were identified as using phencyclidine during pregnancy and 149 were past users. Women with a history of phencyclidine use were compared with a population sample of nonusers. Phencyclidine users were more likely to be white; they were also younger and of lesser parity than nonusers. The majority had a history of multiple drug abuse. Although 7.3% of the population gave a history of phencyclidine use and 0.8% were found to use the drug during pregnancy, these figures are believed to underestimate the problem.

Propoxyphene and Acetaminophen: Possible Effects on the Fetus

Propoxyphene (Darvon®) and acetaminophen (Tylenol®) are widely prescribed analgesic agents. Both can cross the placenta, and propoxyphene can produce serious withdrawal symptoms in newborns. Neither propoxyphene nor acetam inophen is considered a teratogen, yet, three malformed infants who were an tenatally exposed to propoxyphene have previously been reported. We report a fourth case of an infant, with withdrawal symptoms and cranial-facial and digital malformations, born to a woman who used propoxyphene and acetaminophen throughout her pregnancy. We suggest the possibility that the antepartum use of propoxyphene and acetaminophen, in combination, may be teratogenic.

Maternal alcohol use and infant development

A prospective controlled study of the effect of fetal alcohol on infant development was performed. Twelve infants were identified as possibly having fetal alcohol effects based on the maternal history of alcohol abuse and the neonatal physical examination. Physical characteristics, growth, and development of these infants were compared with those of 12 control infants at birth and at a mean age of 12 months; control infants were matched for gestational age, sex, and race. Data were evaluated by descriptive statistics and analysis of differences between matched pairs of study and control infants. The results showed a significant correlation between the history of heavy antenatal maternal alcohol use and delayed mental and motor development, physical abnormalities, and growth retardation in the infants. This study suggests that infants with fetal alcohol effects can be correctly classified at birth and their outcome accurately predicted.