PEDIATRICS Vol. 48 No. 2 August 1971, pp. 178-189
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NEONATAL NARCOTIC ADDICTION: 10 YEAR OBSERVATION

Carl Zelson M.D.1, Estrellita Rubio M.D.1, and Edward Wasserman M.D.1

1 Pediatric Department of the New York Medical College-Metropolitan Hospital Medical Center, New York City

During the 10-year period 1960 through 1969, 384 infants were born to 382 heroin addicted mothers. One hundred ninety (49.4%) of the infants were under 2,500 gm in weight. Seventy -seven (40%) of these were low weight for date infants. Two hundred fifty-nine (67.4%) of the total group of infants developed signs of withdrawal within the first 4 days of life. One hundred seventy-eight or 68.7% of these manifested signs severe enough to require treatment. Eighty-one infants had mild withdrawal signs which cleared without treatment. The 178 treated infants represented 46.3% of the entire group of heroin exposed infants.

Our data indicated that there was a direct correlation between the length of maternal addiction and the occurrence of withdrawal signs in the infants; that with an increase of maternal intake of heroin, there was an increased incidence of neonatal withdrawal; and that the closer to delivery the last dose of heroin was taken, the higher and earlier was the occurrence of withdrawal signs in the neonate.

Response to treatment with chlorpromazine was excellent. The incidence of congenital anomalies was no higher than in the general newbron population. Morphine and quinine could be demonstrated in the urine of the newborn infants within the first 24 hours of life. Fourteen infants (3.6%) died in the neonatal period; nine of these within the first 9 hours after birth. No evidence of Hyaline Membrane disease was found at autopsy in those that died in respiratory distress.

Submitted on August 31, 1970
Accepted on February 8, 1971




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