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Background: Fetal drug addiction is a serious public health problem. In the United
States 10 to 15% of children have been exposed "in utero" to cocaine. In a Chilean
public health service, more than 200 offspring of cocaine free base abuser have
been detected. Aim: To analyze the clinical and social features of 100 children
exposed to cocaine free base during fetal development. Patients and methods:
Clinical features of children born from cocaine free base consume mothers were
described at birth. During subsequent follow up, growth and development, disease
episodes, developmental alterations and social situation were recorded. Data was
compared with other newborns from the same health service. Results: Compared
to their normal counterparts, exposed children has a lower birth weight, the
frequency of premature babies was thrice higher, and small-for-gestational age
children were four times more common. There was also a higher prevalence of
cardiac malformations, seizures and apnea. Hospital admissions were more
frequent, prolonged and required more complex facilities. During follow up,
undernutrition and stunting were more prevalent. Psychomotor retardation was
present in 67% of children and behavioral disturbances in 93%. Most of these
children are governmental protection. Conclusions: Strategies to prevent drug
abuse during pregnancy and its devastating medical and social consequences
should be urgently developed (Rev Md Chile 2000; 128: 1093-1100).
(Key-words: Cocaine-related disorders; Fetal development; Fetal growth
retardation; Pregnancy complications).
El objetivo general fue estudiar sus caractersticas clnicas y sociales. Los objetivos
especficos fueron describir sus caractersticas antropomtricas, los rasgos clnicos y
malformaciones ms frecuentes, su comorbilidad, crecimiento y desarrollo,
conducta y riesgo social asociado.
MATERIAL Y MTODO
A cada nio se le complet una ficha clnica diseada para su seguimiento, con los
antecedentes personales, familiares, rasgos clnicos especiales y el tiempo de
seguimiento. En 1998 se reuni la cohorte de los 100 primeros nios
diagnosticados en el SSMSO.
RESULTADOS
La situacin social de esos menores era diversa: 30% viven con su madre no
rehabilitada, 24% con abuelas, 14% con madre rehabilitada, 8% con tas, 7%
adoptados, 3% en colocacin familiar, 3% en Casa Nacional y en 11% se ignora su
situacin actual.
El antecedente de drogadiccin del padre de estos 100 menores se ignora en 20%.
En el 80% con antecedentes conocidos, 75% se drogaba (pasta base 31%, alcohol
15%, con ambas drogas 12%, polidrogas 12,5%). En 60 abuelos con antecedentes
conocidos, el consumo excesivo de alcohol estaba presente en el 25% de las
abuelas maternas, 60% de los abuelos maternos, 3,3% abuelas paternas y 33%
abuelos paternos.
DISCUSIN
Entre los rasgos clnicos la literatura menciona los Sndromes Piramidales, los que
son bastante frecuentes y transitorios en el primer ao de vida 14. Tambin se
describen frecuentemente las hemorragias cerebrales9. El retraso del DSM
observado es ms acentuado con el abuso de polidrogas. El seguimiento de estos
nios revela que al menos presentan -1DS en las pruebas de DSM15-18.
Correspondencia a: Dra. Mara Mena R. El Director 5593, Las Condes, Santiago 10,
Chile.
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