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Vol. 56. Núm. 3.
Páginas 241-246 (marzo 2002)
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Vol. 56. Núm. 3.
Páginas 241-246 (marzo 2002)
Acceso a texto completo
Toxicidad de la cocaína en el recién nacido. Detección y prevalencia. Identificación de factores de susceptibilidad
Cocaine Toxicity In The Newborn. Detection And Prevalence
Visitas
31942
A. Mur Sierra, O. García-Algar
Autor para correspondencia
90458@imas.imim.es

Correspondencia: Dr. O. García-Algar. Sección de Neonatología. Servicio de Pediatría. Hospital del Mar. P.° Marítim, 25-29. 08003 Barcelona.
, N. López Segura
Sección de Neonatología. Servicio de Pediatría. Hospital del Mar
Este artículo ha recibido
Información del artículo

No se conocen totalmente los efectos del uso prenatal de la cocaína en los recién nacidos y aunque en algunas series de mujeres consumidoras puras de cocaína se han descrito complicaciones graves, últimamente han aparecido publicaciones y revisiones que cuestionan algunos de los posibles efectos perjudiciales de la cocaína sobre el feto y el recién nacido.

En la actualidad el consumo de cocaína está experimentando un notable aumento en nuestro medio y en muchos países, y esto hace prever un aumento de la incidencia de los posibles efectos adversos de la droga sobre el feto y el recién nacido.

Se revisan los posibles efectos del consumo de cocaína durante el embarazo sobre el feto y el recién nacido, resaltando especialmente las alteraciones neuroconductuales que se presentan incluso si el consumo se limitó al primer trimestre de la gestación.

También se analizan los diversos biomarcadores de los que se dispone para detectar la exposición prenatal a la cocaína y finalmente, los factores de susceptibilidad, tanto farmacogenéticos como la relación dosis-respuesta.

Palabras clave:
Cocaína
Recién nacido
Embarazo
Toxicidad de la co-caína
Alteraciones neuroconductuales
Biomarcadores

The neonatal effects of fetal cocaine exposure are not completely known. Serious adverse effects have been described in several series of women consuming pure cocaine, but in recent years articles questioning some of the damaging effects of cocaine on the fetus and newborn have been published.The use of cocaine is currently increasing both in Spain and in many other countries and this will in turn lead to an increase in the incidence of fetal and neonatal adverse effects.

We review the possible effects of cocaine exposure in utero, and place particular emphasis on neurobehavioral abnormalities, which are present even when exposure is limited to the first trimester of pregnancy. We also analyze various biomarkers for cocaine detection in newborns and their mothers and, finally, we review pharmacogenetic and dose-response relation susceptibility factors.

Keywords:
Cocaine
Newborn
Pregnancy
Cocaine toxicity
Neu-robehavioral alterations
Biomarkers
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Bibliografía
[1.]
A. García, A. Mur.
Cocaína y embarazo: repercusión sobre la gestante, el feto y el recién nacido.
Med Clin (Barc), 93 (1989), pp. 538-542
[2.]
M. Viñolas, A. Mur, M.A. López, J.M. Pujals.
Resultados perinatales del hijo de madre cocainómana.
An Esp Pediatr, 42 (1995), pp. 49-51
[3.]
M. Behnke, D. Davis, C.W. Garvan, K. Wobie.
The search for congenital malformations in newborns with fetal cocaine exposure.
Pediatrics, 107 (2001), pp. 74
[4.]
A.M. Dusick, R.F. Covert, M.D. Schreiber, G.T. Yee, S.P. Browne, C.M. Moore.
Risk of intracranial hemorrhage and other adverse outcomes after cocaine exposure in a cohort of 323 very low birth weight infants.
J Pediatr, 122 (1993), pp. 438-445
[5.]
H.L. Cohen, J.H. Sloves, S. Laungani, L. Glass, P. DeMarinis.
Neurosonographic findings in full-term infants born to maternal cocaine abusers: Visualization of subependymal and periventricular cysts.
J Clin Ultrasound, 22 (1994), pp. 327-333
[6.]
M. Behnke, D. Davis, M. Conlon, K. Wobie, N. Stewart, W. Cumming.
Incidence and description of structural brain abnormalities in newborns exposed to cocaine.
J Pediatr, 132 (1998), pp. 291-294
[7.]
C.A. Chiriboga, J.C. Brust, D. Bateman, W.A. Hauser.
Dose-response effect of fetal cocaine exposure on newborn neurologic function.
Pediatrics, 103 (1999), pp. 79-85
[8.]
J.M. Miller, M.C. Boudreaux.
A study of antenatal cocaine use-Chaos in action.
Am J Obst Gynecol, 180 (1999), pp. 1427-1431
[9.]
La cocaína, abuso y adicción. NIDA. Series Reports. 2001. (http://www.nida.nih.gov)
[10.]
W. Chavkin.
Cocaine and pregnancy time to look at the evidence..
Jama, 285 (2001), pp. 1626-1628
[11.]
C.A. Chiriboga.
Neurological correlates of fetal cocaine exposure.
Am N Y Acad Sci, 846 (1998), pp. 109-125
[12.]
D.A. Frank, M. Augustyn, W.G. Knight, T. Pell, B. Zuckerman.
Growth, development and behavior in early childhood following prenatal cocaine exposure. A systematic review.
Jama, 285 (2001), pp. 1613-1625
[13.]
D.F. Askin, B. Diehl-Jones.
Cocaine: Effects of in utero exposure on the fetus and neonate.
J Perinat Neonatal Nurs, 14 (2001), pp. 83-102
[14.]
J.J. García, J. Ramos, A. Martínez, C. Díaz, I. Pascual.
Intoxicación aguda por cocaína en un lactante.
An Esp Pediatr, 33 (1990), pp. 582-583
[15.]
A. Gallart.
Repercusión del consumo de drogas en el recién nacido.
An Esp Pediatr, 33 (1990), pp. 234-241
[16.]
R.J. Konkol, L.J. Murphey, D.M. Ferriero, D.A. Dempsey, G.D. Olsen.
Cocaine metabolites in the neonate: Potential for toxicity.
J Child Neurol, 9 (1994), pp. 242-248
[17.]
J. Oyler, W.D. Darwin, K.L. Preston, P. Suess, E.J. Cone.
Cocaine disposition in meconium from newborns of cocaine-abusing mothers and urine of adult drug users.
J Anal Toxicol, 20 (1996), pp. 453-462
[18.]
S. Schenker, Y. Yang, R.F. Johnson, J.W. Downing, R.S. Schenken, G.I. Henderson.
The transfer of cocaine and its metabolites across the term human placenta.
Clin Pharmacol Ther, 53 (1993), pp. 329-339
[19.]
D.A. Bateman, C.A. Chiriboga.
Dose-response effect of cocaine on newborn head circumference.
Pediatrics, 106 (2000), pp. 33
[20.]
L.T. Singer, T.S. Yamashita, S. Hawkins, D. Cairns, J. Baley, R. Kliegmen.
Increased incidence of intraventricular hemorrhage and development delay in cocaine-exposed, very low birth weight infants.
J Pediatr, 124 (1994), pp. 765-771
[21.]
D.A. Frank, K.M. McCarten, C.D. Robson, M. Mirochnick, H. Cabral, H. Park.
Level of in utero cocaine exposure and neonatal ultrasound findings.
Pediatrics, 104 (1999), pp. 1101-1105
[22.]
D.A. Frank, M. Augustyn, B.S. Zuckerman.
Neonatal neurobehavioral and neuroanatomic correlates of prenatal cocaine exposure problems of dose and confounding.
Ann N Y Acad Sci, 846 (1998), pp. 40-50
[23.]
L.T. Siner, R. Arendt, S. Minnes, A. Salvator, A.C. Siegel, B.A. Lewis.
Developing language skills of cocaine-exposed infants.
Pediatrics, 107 (2001), pp. 1057-1064
[24.]
H. Hurt, J. Giannetta, N.L. Brodsky, E. Malmud, T. Pelham.
Are the neurologic correlates of in utero cocaine exposure at age 6 yearsα.
J Pediatr, 138 (2001), pp. 911-915
[25.]
L.M. Smith, L. Chang, L. Yonekura, C. Grob, D. Osborn, T. Ernst.
Brain proton magnetic resonance spectroscopy and imaging in children exposed to cocaine in utero.
Pediatrics, 107 (2001), pp. 227-231
[26.]
E.M. Ostrea, D.K. Knapp, L. Tannenbaum, A.R. Ostrea, A. Romero, V. Salari.
Estimates of illicit drug use during pregnancy by maternal interview, hair analysis, and meconium analysis.
J Pediatr, 138 (2001), pp. 344-348
[27.]
M.A. ElSohly, W. Kopycki, S. Feng, T.P. Murphy.
Identification and analysis of the major metabolites of cocaine in meconium.
J Anal Toxicol, 23 (1999), pp. 446-451
[28.]
C.H. Fox.
Cocaine use in pregnancy.
J Am Board Fam Pract, 7 (1994), pp. 225-228
[29.]
P.R. Marques, A.S. Tippetts, D.S. Branch.
Cocaine in the hair of mother-infant pairs: Quantitative analysis and correlations with urine measures and self-report.
Am J Drug Alcohol Abuse, 19 (1993), pp. 159-175
[30.]
J. Klein, T. Karaskov, G. Koren.
Clinical applications of hair testing for drugs of abuse the Canadian experience.
Forensic Sci Int, 107 (2000), pp. 281-288
[31.]
P. Kintz, P. Mangin.
Determination of gestational opiate, nicotine, benzodiazepine, cocaine and amphetamine exposure by hair analysis.
J Forensic Sci Soc, 33 (1993), pp. 139-142
[32.]
G. Koren.
Measurement of drugs in neonatal hair; a window to fetal exposure.
Forensic Sci Int, 70 (1995), pp. 77-82
[33.]
S. Samperiz, V. Millet, J. Arditti, V. Lacroze, D. Masset, H. Bourdon.
Value of toxicological research in newborn infants of addicted mothers by the study of several samples.
Arc Pediatr, 3 (1996), pp. 440-444
[34.]
F. Ursitti, J. Klein, G. Koren.
Clinical Utilization of the neonatal hair test for cocaine: A four-year experience in Toronto.
Biol Neonate, 72 (1997), pp. 345-351
[35.]
G. Koren, J. Klein, K. McMartin.
Diagnosing intrauterine exposure to cocaine by hair testing: six years of clinical use.
Ther Drug Monit, 20 (1998), pp. 478-480
[36.]
M.G. Ladona, M.L. Gonzalez, A. Rane, R.M. Peter, R. De la Torre.
Cocaine metabolism in human fetal and adult liver microsomes is related to cytochrome P-450 3A expression.
Life Sci, 68 (2000), pp. 431-443
[37.]
P. Pellinen, L. Kulmala, J. Konttila, S. Auriola, M. Pasanen, R. Juvonen.
Kinetic characteristics of norcocaine N-hydroxylation in mouse and human liver chromosomes: Involvement of CYP enzymes.
Arch Toxicol, 74 (2000), pp. 511-520
[38.]
B.M. Lester, M.A. ElSohly, L.L. Wright, V.L. Smeriglio, J. Verter, C.R. Bauer.
The Maternal Lifestyle Study: Drug use by meconium toxicology and maternal self-report.
Pediatrics, 107 (2001), pp. 309-317
Copyright © 2002. Asociación Española de Pediatría
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