Developmental consequences of maternal drug use during pregnancy.
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Child Behavior↗
Biomedical subjects
B Zuckerman
Publications and source records attributed to B Zuckerman.
Alcohol consumption by pregnant women.
Demographic and behavioral characteristics, including use of alcohol, were investigated among 1711 women registering for prenatal care at Boston City Hospital. During personal interviews, 9% reported drinking heavily, 37% moderately, and 53% rarely or not at all. The women who drank heavily differed from the rest of the pregnant population on several traits, including age, education, use of cigarettes, marijuana and other drugs, parity, and association with others who drank heavily. Multiple regression analysis revealed that these traits had little predictive power for whether a woman was a heavy drinker. A systematic drinking history remains the most practical method in identifying problem drinkers.
Adult↗
Patterns of alcohol consumption and fetal development.
Effects of heavy, moderate, and rare alcohol consumption on fetal development were analyzed in a prospective study of 469 mother-infant pairs. Differential effects of heavy drinking in early and late gestation were evaluated by separate analysis of neonates born to women who reduced consumption before the third trimester. Using chi 2 analysis, multiple regression, and matched sets, statistically significant associations (P less than .01) were observed between sustained heavy drinking and both intrauterine growth retardation and congenital anomalies. These associations were independent of eight other risk factors. No differences were observed between offspring of rare and moderate drinkers. Infants born to women who reduced heavy drinking did not differ in growth from offspring of rare and moderate drinkers but demonstrated a higher frequency of abnormalities. Sustained heavy drinking represents a major risk; reduction in midpregnancy can benefit the newborn. Identification and therapy of heavy drinking are important components of prenatal care.
Abnormalities, Drug-Induced↗
Neonatal outcome: is adolescent pregnancy a risk factor?
It has been widely reported that adolescent mothers are more likely to experience poor pregnancy outcome, especially low-birth-weight and/or premature infants. Recent data suggest that this poor outcome may be attributed to confounding health and social characteristics of adolescent mothers. A study of maternal health and neonatal development at Boston City Hospital provided an opportunity to assess whether adolescent mothers deliver infants with poorer outcomes at birth than nonadolescents independent of numerous social and health differences between adolescent and nonadolescent mothers. A total of 275 infants of primiparous adolescents (aged 13 to 18 years) were compared at birth with 423 infants of primiparous nonadolescents. Size at birth, length of gestation, Apgar scores, and birth trauma were examined. The only statistically significant difference between the two groups was that adolescent mothers delivered infants whose mean weight was 94 g less (P less than .03) than infants of nonadolescent mothers. Multiple and logistic regression analyses demonstrated that several health and social factors, but not adolescent status, were independently associated with the measures of adverse infant outcome. A subsequent regression analysis demonstrated similarly that being a younger adolescent (16 years and younger) did not independently predict low birth weight at delivery or other measured adverse neonatal outcomes. These data support the view that health and social factors are more important to poor fetal outcome among primiparous mothers than adolescent status. Some of the health factors are amenable to clinical intervention.
Adolescent↗
Another myth: reduced hospital visiting by inner-city mothers.
Hospitalization of young children produces stress that can be reduced by the presence of a parent. Inner-city parents, however, are generally believed to visit the hospital less often than more affluent parents. At Boston City Hospital pediatric nursing and medical staff (N = 60) were surveyed to obtain their impressions of maternal visiting and its determinants; then 80/94 consecutive admissions of children less than age 5 years were surveyed to record the mothers' actual visiting times. Each mother was interviewed to determine sociodemographic status, her perception of her child's behavior, and her perception about visiting. The staff believed that few mothers (20%) would visit more than 4 h/d, but the study showed that nearly three times this many mothers did visit more than 4 h/d. The median visit length was five hours, and 20% of the mothers roomed-in at least once. Contrary to staff expectations, neither job nor child care responsibilities were related to visit length. Mothers who thought visits helped their children visited longer (10.6 v 5.3 hours, P less than .001). Contrary to staff beliefs, most inner-city mothers successfully overcame external and emotional barriers to visiting their hospitalized children. Staff input and an educational effort might facilitate longer visits by the one third of mothers who did not recognize the importance of their visiting their children.
Attitude of Health Personnel↗
Maternal cigarette smoking, psychoactive substance use, and infant Apgar scores.
A study of 1,709 mother/child pairs at Boston City Hospital examined whether maternal cigarette smoking, drinking, or the use of other psychoactive substances was associated with low infant Apgar scores. The potential confounding effects of other labor and delivery risks were controlled in the analysis. In contrast to previous reports, univariate and stepwise multiple regression analyses did not identify a significant negative association between cigarette smoking and 1- or 5-minute Apgar scores. None of the substance use variables was significantly associated with low infant Apgar scores at 1 and 5 minutes. Other labor and delivery risks, such as short length of gestation, abnormal delivery presentation, placental abnormalities, nuchal cord, and exposure to general anesthesia during delivery, were associated with low Apgar scores.
Adult↗
Bendectin and fetal development. A study of Boston City Hospital.
As part of a prospective study investigating maternal characteristics and habits during pregnancy and their impact on fetal development, 1,690 mother/infant pairs were studied. Of the mothers, 375 reported using Bendectin during pregnancy. Multivariate analyses examining birth weight, length, head circumference, gestational age, and congenital malformations as dependent variables demonstrated no associations between Bendectin exposure and adverse fetal outcome.
Abnormalities, Drug-Induced↗
Effects of maternal drinking and marijuana use on fetal growth and development.
A study of 1,690 mother/child pairs at Boston City Hospital was conducted to assess the impact of maternal alcohol consumption on fetal development when confounding variables were controlled. Level of maternal drinking prior to pregnancy was associated with shorter duration of gestation. Lower maternal weight change, history of maternal illnesses, cigarette smoking, and marijuana use, however, were more consistently related to adverse fetal growth and development. New findings in this study include a negative association between maternal marijuana use during pregnancy and fetal growth. Also when confounding variables were controlled, women who used marijuana during pregnancy were five times more likely to deliver infants with features considered compatible with the fetal alcohol syndrome.
Abnormalities, Drug-Induced↗
Maternal alcohol consumption and newborn assessment: methodology of the Boston City Hospital prospective study.
This paper describes the methods of the Maternal Health and Child Development of Project at the Boston City Hospital which explored the impact of maternal drinking prior to and during pregnancy on fetal development. Between February 1977 and October 1979, of 3222 women who delivered single infants, 1690 were interviewed in hospital after delivery and their babies examined by a pediatrician who was unaware of the interview results. The 1690 mother-infant pairs of whom both interview and exam are available did not systematically differ from the 272 for whom the interview only or 824 for whom the exam only was conducted. Interviews were also collected prenatally in the Boston City Hospital's Women's Clinic, from 470 women whose infants were examined. Maternal and infant characteristics are described. Heavy drinkers were much more likely to smoke cigarettes and to have used psychoactive drugs than lighter drinkers. Heavy drinkers also differed from non-heavy drinkers on several other factors which may influence fetal development.
Adolescent↗
Reduction of alcohol consumption during pregnancy with benefits to the newborn.
Among a group of 69 pregnant women who drank heavily, 25 reduced alcohol consumption before the third trimester. Infants born to these women showed less growth retardation than did infants born to 44 women who continued to drink heavily throughout the pregnancy. Analysis of other risk factors showed little effect on outcome when third trimester drinking patterns were held constant, Identification and counseling of heavy-drinking pregnent women should provide benefits for both the mother and her newborn.
Alcohol Drinking↗
A study of attitudes and support systems of inner city adolescent mothers.
Because the simultaneous demands of adolescence and motherhood could result in special infant rearing attitudes and concerns, a prospective pilot study of inner city adolescent mothers was undertaken. A sample of primiparous adolescent mothers was compared with primiparous and multiparous nonadolescent mothers. Data were collected by home interviews at two weeks and three months postpartum. The major hypothesis, that the simultaneous occurrence of adolescence and motherhood would result in special infant rearing attitudes, concerns, and support systems which interfered with mothering, was not fully supported by our findings. Few of the adolescent mothers were married (8%) but of those not married, most (95%) lived in an extended family. Adolescent mothers, when compared with older mothers, were more likely to seek medical advice from their mothers as opposed to health professionals and were more insecure in their maternal self-image if caretaking was shared. Attitudinal differences around feeding were seen, but attitudes about spoiling, perception of the baby's behavior, discipline, caretaking, and enjoyment were the same among groups. Adolescent mothers and their infants provide physicians and other child health professional with a special pediatric family. The differences in available support systems and maternal self-image suggest areas for further investigation.
Adaptation, Psychological↗
Importance of behavioral assessment of the neonate.
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Apgar Score↗
Structure of dye aggregates and the mechanism(s) of photosensitization of AgBr.
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Bromides↗
Developing an arrhythmia course for obstetric nurses.
The need has increased for high-risk obstetric nurses to interpret cardiac rhythms, owing to the potential cardiovascular side-effects of tocolytic therapy in premature labor. The cardiovascular critical care nurse, educator, and clinical specialist are important to obstetric nurses as consultants for arrhythmia interpretation. These authors describe how to plan, develop, and implement an arrhythmia course for staff nurses working in obstetric units.
Arrhythmias, Cardiac↗
A mediational model for the impact of exposure to community violence on early child behavior problems.
This study examined how maternal distress mediates the link between exposure to community violence (CV) and the development of early child behavior problems. Research was conducted among 160 children, 3,0 to 5,11 in age, who resided in high-crime neighborhoods. Using structural equation modeling, latent variables were constructed to identify model components: maternal socioeconomic status (SES) and public assistance status, exposure to CV (maternal perceptions of local violence, social disorder, and fear of crime; and frequency of child cowitnessing violent events), family aggression (partner aggression toward mother and partner aggression toward child), maternal distress (global distress and posttraumatic stress disorder symptoms), and early child behavior problems (internalizing and externalizing). Bivariate correlations indicated that CV, maternal distress, and early child behavior problems were significantly intercorrelated. A series of structural equation models was specified to estimate the direct and indirect effect of CV on early child behavior problems. A direct model indicated a significant path from CV to early child behavior problems, after controlling for maternal SES and family aggression. The direct CV-early child behavior problems path diminished, however, when maternal distress was included in the model, after controlling for maternal SES and family aggression. Results are consistent with a mediation model of the impact of maternal distress symptoms on the link between CV and early child behavior problems.
Black or African American↗
State health care reform in Massachusetts.
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Adolescent↗
Prenatal cocaine use: impact on infants and mothers.
Prenatal cocaine use does not allow a mother to provide an environment that promotes her infant's normal development. Pediatric nurses and other health care professionals need to support and assist the mother in the recovery process for the benefit of the child's health and development.
Adult↗