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Biomedical subjects

B Zuckerman

Publications and source records attributed to B Zuckerman.

At least 37 records · Page 2Linked to original sources
PubMed1994

Witnessing violence by young children and their mothers.

Witnessing violence can have an adverse effect on children and adults. To determine the prevalence and selected correlates of witnessing violence among young children and their mothers, we consecutively recruited 143 parents (88% of those eligible) with children 1 to 5 years of age from the pediatric primary care clinic at Boston City Hospital. The final sample of 115 mothers were English-speaking, primarily minority and poor (76% living on < $10,000/year). In response to a standardized questionnaire, 10% of children were reported to have witnessed a knifing or shooting; 18% had witnessed shoving, kicking, or punching; and 47% had heard gunshots. Thirty-six percent of the mothers reported witnessing a knifing or shooting and 9% had been victims of a knifing or shooting. Mothers of children who had witnessed violence were more likely to limit their movements (80% vs 50%, p < .003) and were more concerned about safety (67% vs 24%, p < .001) compared to mothers whose children did not witness violence. This finding needs to be replicated in other settings, and potential consequences need to be identified.

Adult↗
PubMed1993

Adolescent pregnancy in Portugal: effectiveness of continuity of care by an obstetrician.

OBJECTIVE: To improve health among newborn infants of pregnant adolescents in Portugal, we developed and evaluated a prenatal care intervention. METHODS: The study group consisted of 80 adolescents recruited as they registered for prenatal care at Hospital Santa Maria in Lisbon. The intervention consisted of three components: initiation of prenatal care at registration, continuity of care by the same obstetrician, and emphasis on the specific nutritional and other health needs of pregnant adolescents. Controls were recruited after delivery on the maternity ward of the same hospital and were matched for age at conception, race, socioeconomic status, years of education, planned versus unplanned pregnancy, and previous body mass index. Controls received the routine care provided to pregnant adult women, including initiation of prenatal care at some point after registration and care by different general practitioners at each visit. RESULTS: Twenty mothers in the control group did not receive prenatal care and were excluded from further analysis. Mothers in the intervention group had their first prenatal visit 2 weeks sooner (P = .02) and had on average almost twice the number of prenatal visits (P = .0001) as controls. They gained 2.0 kg more on average compared with controls (P = .05). Infants of the mothers in the intervention group weighed an average of 181 g more than those in the control group. Fewer infants in the intervention group needed care in the high-risk pediatric unit (P = .005). When potentially confounding variables were controlled in a multivariate analysis, infants in the intervention group weighed on average 174 g more than those in the routine-care group (P = .02). CONCLUSION: This intervention, based on traditional tenets of good medical care, is effective in improving the outcomes of infants born to adolescent mothers in Portugal.

Adolescent↗
PubMed1993

Cerebrospinal fluid monoamine precursors and metabolites in human neonates following in utero cocaine exposure: a preliminary study.

BACKGROUND: Cocaine acts in the central nervous system by increasing dopamine release and inhibiting the reuptake of dopamine and other monoaminergic neurotransmitters. Prenatal cocaine exposure may cause neurochemical changes in developing monoaminergic neurons and might alter brain structure and function. No data have been published on central nervous system monoamine precursors and metabolites in human neonates exposed prenatally to cocaine. METHODS: Cerebrospinal fluid (CSF) was obtained from neonates undergoing lumbar puncture to rule out infection. The CSF was analyzed for the neurotransmitter precursors and metabolites tryptophan, tyrosine, 3-methoxy-4-hydroxyphenylglycol, homovanillic acid, and 5-hydroxyindoleacetic acid. Drug exposure was ascertained by medical record review and urine and meconium assays. RESULTS: Eleven neonates were cocaine-exposed, based on positive meconium or urine assays for benzoylecgonine; 20 were unexposed, based on both negative history and assay. The exposed and unexposed groups did not differ significantly in gender, perinatal stress, clinical illness, or exposure to other illicit drugs, but did differ in mean gestational age, growth parameters, and exposure to cigarettes. Cocaine-exposed neonates had significantly lower levels of CSF homovanillic acid (mean 148.1 vs 218.5 ng/mL, P = .01). The magnitude of this difference was similar after correcting for each of four potential confounding factors, although no longer statistically significant in all cases (P values ranged from .044 to .17). No significant differences were observed for tyrosine, tryptophan, 5-hydroxyindoleacetic acid, or 3-methoxy-4-hydroxyphenylglycol. CONCLUSIONS: These preliminary results suggest an association between prenatal cocaine exposure and decreased CSF homovanillic acid, the principal metabolite of dopamine. Prenatal cocaine exposure may result in changes in central dopaminergic systems in the human neonate.

Biogenic Monoamines↗
PubMed1992

Psychosocial correlates of drug and heavy alcohol use among pregnant women at risk for drug use.

OBJECTIVE: To investigate the roles of life stress, depression, and social support in the use of drugs and alcohol among pregnant women at risk for substance use because they have a substance-using partner. METHODS: This is a secondary analysis of data collected for a study of the impact of health behaviors and psychosocial characteristics on the newborns of 1226 pregnant women. Participants were interviewed during pregnancy and postpartum using a questionnaire that included instruments such as the Life Experiences Survey, the Center for Epidemiologic Studies Depression Scale, and the Norbeck Social Support Questionnaire. Drug use by women was determined by self-report and urine toxicology screens. Drug use by partners was based on maternal report. RESULTS: Five hundred seventy-three women reported that they had a substance-using partner. These women were nearly five times more likely (odds ratio 4.87, 95% confidence interval 3.76-6.30) to be substance users compared with women who did not report substance use by a partner. Of these women, substance users reported more negative life events on average in the past year than did non-users (19.3 versus 15.8; P = .01). There was no difference in mean Center for Epidemiologic Studies Depression Scale scores (19.7 versus 18.7; P = .26) or in mean social support scores (78.2 versus 72.4; P = .14) between users and non-users. CONCLUSIONS: Women with substance-using partners have an increased likelihood of being users themselves. Among women with substance-using partners, substance use by a pregnant women is associated with more negative life events but not with depression symptomatology scores or social support scores.

Adult↗
PubMed1992

Reducing night waking in infancy: a primary care intervention.

Approximately 25% of infants wake regularly at night and need help in resettling. The purpose of this study was to implement and evaluate a brief intervention to prevent such night waking. The study used a prospective cohort design with historical controls. Information from the control group was collected at the 9-month visit. The intervention group was enrolled at the 4-month visit. The intervention consisted of information about sleep-onset associations, completion of a sleep chart, and discussion about sleep with the pediatrician. The outcome was also measured at the 9-month visit. To obscure the purpose of the study, the outcome questionnaire for both groups addressed feeding and sleeping. One hundred twenty-eight (74%) of 172 eligible infant-parent pairs comprised the control group and 164 (74%) of 222 the intervention group. The majority of families were white, married, and well-educated. The groups were similar with regard to sociodemographic variables and factors thought to be related to night waking such as current breast-feeding, thumb/pacifier sucking, maternal isolation, and parental perception of difficult child. At 9 months of age, the intervention infants were reported to experience 36% less night waking per week compared with those in the control group (2.5 vs 3.9 wakings per week, P = .02). Frequent night waking was twice as common in control infants (27% vs 14%, P = .01). It is concluded that this pediatric intervention can help parents reduce night waking in infants.

Cohort Studies↗
PubMed1991

A preliminary report of prenatal cocaine exposure and respiratory distress syndrome in premature infants.

A prospective study of maternal drug use during pregnancy and newborn outcomes provided us with an opportunity to assess the relationship between prenatal cocaine use and respiratory distress syndrome among premature infants. Women were consecutively recruited from the prenatal clinics at Boston (Mass) City Hospital between 1984 and 1988 and were interviewed during the prenatal and postpartum period by trained bilingual interviewers. Urine specimens were collected at the time of each interview and were analyzed for marijuana and cocaine metabolites. Following delivery, one of five pediatricians who were "blinded" to the mothers' prenatal and drug history performed a physical examination and abstracted medical information, including the diagnosis of respiratory distress syndrome from the medical record. The study sample consisted of 33 infants born at 34 weeks' or less gestation who were appropriate for gestational age and not exposed to heroin or methadone prenatally. Eight of the mothers of these 33 infants used cocaine prenatally. One (12%) of eight cocaine-exposed infants was diagnosed as having respiratory distress syndrome compared with 13 infants (56%) not exposed to cocaine prenatally. Infants not exposed had an odds ratio of 8.9 (95% confidence interval: 0.9, 83.5) for respiratory distress syndrome compared with infants exposed to cocaine prenatally. When the analysis was controlled for prolonged rupture of membranes, black race, infant gender, or gestational age, the adjusted odds ratio was essentially unchanged. This preliminary observation of a decreased incidence of respiratory distress syndrome among premature infants prenatally exposed to cocaine appears to be biologically plausible and needs to be confirmed in future studies with larger numbers of subjects to control for potentially confounding variables.

Adult↗
PubMed1991

Clinic-based intervention to promote literacy. A pilot study.

Educational research has shown that children become literate more easily if their parents read to them. A clinic-based program was designed to encourage early book use among parents of children at risk. It included (1) waiting room readers, (2) guidance about literacy development, and (3) provision of children's books at each visit. Seventy-nine parents of children aged 6 to 60 months were interviewed. Parents who had previously received a book were more likely to report looking at books with their children or that looking at books was a favorite activity (adjusted odds ratio, 4.05). This association was strongest among parents receiving Aid to Families With Dependent Children (odds ratio, 7.8). This preliminary study suggests that pediatricians can play a role in enriching children's early literacy environments, especially for children at high risk of school failure.

Aid to Families with Dependent Children↗
PubMed1991

Developmental and behavioral consequences of prenatal drug and alcohol exposure.

This article summarizes what is known about the effects of cocaine, opiates, marijuana, and alcohol on neonatal and postnatal growth and development. The development of a child affected by prenatal exposure to drugs and alcohol is best understood through a multifactorial model consisting of interrelated prenatal and postnatal factors. The article also describes the prenatal effects of drugs and alcohol on the newborn, especially on central nervous system functioning, which is seen as creating a biologic vulnerability that renders a child more vulnerable to the effects of poor caretaking.

Alcoholism↗