Born with a Habit
Pediatric Clinics of North AmericaPublished 1 May 1974
Peter Rothstein, Jeffrey B. Gould
Citations69
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TL;DR
In many urban hospitals the neonate manifesting signs of narcotics withdrawal is becoming well known in special care nurseries and the question of whether methadone maintenance or detoxification should be carried out in the pregnant addict is raised.
Abstract
In many urban hospitals the neonate manifesting signs of narcotics withdrawal is becoming well known in special care nurseries. Neonatal withdrawal and its treatment are discussed in some detail. The fact that heroin and methadone are both toxic to the fetus raises the question of whether methadone maintenance or detoxification should be carried out in the pregnant addict.
Keywords
MedicineNeuroscience
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It is suggested that an association exists between general major organ system maturation of the fetus—“functional maturity”-and the L/S ratio, independent of gestational age or birth weight.
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The increase in cycle length with maturation was not significant, but there was a significant change in the proportion of quiet to active sleep within a cycle.
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131 Citations1973JoséLuis Rementería, Nemesio N. Nunag
Mechanisms are presented to help explain the possible relationship between the maternal withdrawal and the fetal death and an increased stillborn and neonatal mortality rate in the over-all pregnant drug-addicted population.
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125 Citations1971Martin L. Stone, Louis J. Salerno +2 more
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86 Citations1972Paul S. Pierson
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JAMAMedical Disorders in Drug Addicts
85 Citations1973Abraham G. White
The cases of 200 patients admitted to the Bernstein Institute Medical Inpatient Unit (Beth Israel Medical Center, New York) were analyzed according to epidemiologic, demographic, and diagnostic characteristics.
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83 Citations1969E. Kahn, Lois L. Neumann +1 more
In a study of the relative efficacy of phenobarbital and chlorpromazine in the treatment of the syndrome, 30 infants became asymptomatic within 4 days; no definite superiority could be attributed to either drug on the basis of this trial.
The Journal of PediatricsHeroin induction of lung maturation andgrowth retardation in fetal rabbits
81 Citations1973H. William Taeusch, Stephen H. Carson +2 more
Injected fetuses of pregnant does and fetal rabbits had decreased body weight and lung maturation equivalent to that of 29 to 30 day fetuses when delivered at 27 days, which may explain why infants born to heroin-addicted mothers have less than the expected incidence of hyaline membrane disease.
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Study of 300 pregnant addicts voluntarily treated with medical withdrawal on methadone in the Detoxification Program found increased incidences of low birth weights, meconium, and breech presentations, but problems with the newborns were not significantly increased.
New England Journal of MedicineInfant of the Addicted Mother
69 Citations1973Carl Zelson
With the increasing incidence of drug addiction in general, and since 85 per cent of the women involved are in the childbearing age, one would thus also expect an increase in the number of births of infants of drug-addicted mothers.
JAMAMethadone Maintenance, Pregnancy, and Progeny
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Journal of the American Academy of Child PsychiatryTHE CHILDREN OF DRUG USERS
63 Citations1973Sol Nichtern
There has been a significant rise in the number of children born of drug-addicted parents in recent years and many have been referred to child placement agencies for shortor long-term care away from their drug-using parents, prompting this review of such children being cared for by the Jewish Child Care Association of New York.
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54 Citations1947Meyer A. Perlstein
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49 Citations1967Johanna F. Perlmutter
Although menstrual abnormalities were found in this group of patients, it did not seem to affect their fertility, and neonatal addiction was found in 54.5 per cent of the live babies delivered.
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48 Citations1971Gerald Nathenson, Gerald S. Golden +1 more
Diazepam appears to be a safe and effective drug for the treatment of neonatal narcotic withdrawal symptoms and control may be quickly achieved with a short course of therapy without serious side effects or the occurrence of rebound symptoms when the therapy is discontinued.
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JAMABarbiturate Withdrawal Syndrome in a Passively Addicted Infant
42 Citations1972Werner A. Bleyer
The authors believe the patient represents the first recorded case of neonatal barbiturate withdrawal syndrome and that congenitalBarbiturate addiction is more common than realized.
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This report calls your attention to some important observations relating to the general problem of narcotic and methamphetamine use in the general population.
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Eighteen pregnant patients with heroin addiction and their newborn babies were studied and the cases were analyzed as to method of delivery, postpartum complications and treatment, fetal salvage and fetal deaths, birth weight, fetal complications and Treatment.
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Maintenance on the smallest daily dose of methadone hydrochloride which would prevent withdrawal symptoms has been studied in 150 pregnant addicts, and evidence of withdrawal was observed in 72 of 90 infants.
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27 Citations1971Saul Blatman
The increasing use of methadone maintenance (substitution) programs1-3 in the treatment of adult heroin addiction has created situations for children which require the attention of pediatricians.
Journal of the American Medical AssociationNARCOTIC WITHDRAWAL SYMPTOMS IN NEWBORN INFANTS
23 Citations1958Ralph H. Kunstadter
There may be symptoms and signs of narcotic withdrawal in those born of addicted mothers and these usually become manifest within hours after birth and, if unrecognized and untreated early, the infant may die.
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21 Citations1972Gerald Nathenson, Michael I. Cohen +2 more
The finding of increased bilirubin glucuronyl transferase activity in morphine-addicted mice and the morphologic demonstration of an increase in the smooth endoplasmic reticulum of their liver cells as seen by electron microscopy suggested a possible mitigating effect of heroin on bilirUBin accumulation in the newborn infant.
Archives of General PsychiatryWakefulness and Feeding in Human Newborns
17 Citations1973Theodore J. Gaensbauer
This study compared behavioral states of 30 demand-fed and 30 schedule-fed newborns observed during a single feeding-to-feeding period to prove the hypothesis that the distribution of alert wakefulness in relation to feeding is altered by the type of feeding regimen used.
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15 Citations1971David Annunziato
In a recent effort to alert the members of the authors' chapter to the increasing incidence of infants born manifesting withdrawal symptoms due to their mother's heroin addiction, the impression was that no symptoms occurred in the infants of mothers on methadone.
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Among infants born to mothers taking methadone, the severity of the neonatal withdrawal syndrome, as reflected in both these measures, is an inverse function of birthweight-with lower weight babies tending to be more behaviorally affected by maternal addiction.
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It is concluded that careful consideration should be given to the drugs a patient may be taking when fetal well-being is monitored with urinary estriol excretion when methadone-dependent pregnant women are studied in their last trimester of gestation.
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The increasing incidence of drug abuse has caused considerable concern among health professional groups, but the potential biologic hazards of pleasure giving drugs are poorly defined because of the very limited reliable clinical and laboratory data available.
Archives of Pediatrics and Adolescent Medicine45, X Chromosome Abnormality in the Offspring of a Narcotic Addict
6 Citations1972Theodore Kushnick
During a cytogenetic investigation of adult narcotic addicts and their newborn offspring, a female infant with a 45,X karyotype was born to a woman who used heroin and cocaine, and had multiple features consistent with the Turner's syndrome phenotype.