Clinics in Developmental Medicine No. 188 This book documents the consequences of the exposure of infants to the influence of intrauterine chemicals. In setting out the evidence for these outcomes, the authors demonstrate that decisions about care and management can and should be made as early as possible. This should allow professionals to provide protective management and prevent the delays that are so often seen in this area of medical and social care. The international team of contributors sets out to inform the reader of the potential risks to infants exposed to a range of intrauterine chemicals that are potentially neuroactive, including medicinal drugs such as antiepileptics, antidepressants and antipsychotics, as well as drugs of abuse, including alcohol, opiates, and recreational drugs such as cannabis and tobacco. They review the teratogenic action of some of the chemical processes and the relationship of exposure to the stage of pregnancy.
Some agents alter anatomic structure; others alter the chemical balance of neurotransmitters and may thus alter the regulation of brain function, with profound effects on the child's behaviour and propensity to behavioural disturbances. The book explores strategies to support these children and those who care for them, including statutory agencies. Readership Paediatricians, neonatologists, obstetricians, gynaecologists, child and adolescent psychiatrists and psychologists, those working in child care and child protection.
Philip Preece is a consultant paediatrician with training in neurodisability. He manages a range of children with autism spectrum disorders, attention-deficit hyperactivity disorder, and learning difficulties. He has developed an interest in the outcome of infants exposed to prenatal drugs, both medicinal and recreational, as part of his work assessing children prior to adoption. Ed Riley served as Chair of the National Task Force on Fetal Alcohol Syndrome/Fetal Alcohol Effect. He currently serves as the Steering Committee Co-Chair of the Fetal Alcohol Spectrum Disorders Center for Excellence. He has been President of the Research Society on Alcohol, the Fetal Alcohol Study Group, and the Behavioral Teratology Society. He has served as Associate Editor of the Journal of Studies on Alcohol, and is on the Editorial Boards of Alcoholism: Clinical and Experimental Research and the Psychological Record. He has received numerous awards for his scholarship and service, most recently the Research Society on Alcoholism Distinguished Researcher Award.
AUTHORS' APPOINTMENTS vii 1. INTRODUCTION 1 Philip M Preece SECTION 1. NEUROTERATOGENESIS EPIDEMIOLOGY AND PATHOLOGY 2. EPIDEMIOLOGY OF DRUG AND ALCOHOL USE DURING PREGNANCY 11 Ron Gray 3. NORMAL AND ABNORMAL EMBRYOGENESIS OF THE MAMMALIAN BRAIN 23 Kathy K Sulik, Shonagh K O'Leary-Moore, Elizabeth A Godin and Scott E Parnell SECTION 2. LONG-TERM EFFECTS OF MAJOR PRESCRIBED MEDICATIONS 4. EPILEPSY IN PREGNANCY AND THE EFFECT OF PRENATAL ANTIEPILEPTIC MEDICATION 44 Jill Clayton-Smith and Gus Baker 5. NEURODEVELOPMENT OF CHILDREN EXPOSED TO ANTIDEPRESSANT AND ANTIPSYCHOTIC MEDICATIONS DURING PREGNANCY 56 Irene Nulman, Sara Citron, Michelle Todorow and Elizabeth Uleryk SECTION 3. LONG-TERM EFFECTS OF DRUGS OF ABUSE 6. DIAGNOSIS OF FETAL ALCOHOL SYNDROME: EMPHASIS ON EARLY DETECTION 85 Margaret Barrow and Edward P Riley 7. THE EFFECTS OF PRENATAL ALCOHOL EXPOSURE ON BRAIN AND BEHAVIOUR 108 Christie L McGee Petrenko and Edward P Riley 8. EFFECT OF DRUGS OF ABUSE ON THE FETUS: COCAINE AND OPIATES INCLUDING HEROIN 130 Lynn T Singer and Sonia Minnes 9. CANNABIS USE DURING PREGNANCY: ITS EFFECTS ON OFFSPRING FROM BIRTH TO YOUNG ADULTHOOD 153 Peter A Fried 10. IN UTERO EXPOSURE TO THE POPULAR 'RECREATIONAL' DRUGS MDMA (ECSTASY) AND METHAMPHETAMINE (ICE, CRYSTAL): PRELIMINARY FINDINGS 169 Derek G Moore, John J D Turner, Julia E Goodwin, Sarah E Fulton, Lynn T Singer and Andrew C Parrott 11. THE SHORT-TERM AND LONG-TERM DEVELOPMENTAL CONSEQUENCES OF MATERNAL SMOKING DURING PREGNANCY 183 Kate E Pickett and Lauren S Wakschlag SECTION 4. INTERVENTION STRATEGIES TO REDUCE THE IMPACT OF DRUGS AND ALCOHOL IN PREGNANCY 12. MANAGEMENT OF THE EFFECTS OF PRENATAL DRUGS IN CHILDREN OF DRUG-ABUSING PARENTS 197 Faye Macrory and Michael Murphy 13. PRENATAL AND POSTNATAL INTERVENTION STRATEGIES FOR ALCOHOL-ABUSING MOTHERS IN PREGNANCY 217 Ann P Streissguth and Therese M Grant 14. COGNITIVE AND BEHAVIOURAL INTERVENTIONS TO AMELIORATE THE EFFECTS OF FETAL ALCOHOL SPECTRUM DISORDERS IN CHILDREN AND ADOLESCENTS: PROMOTING POSITIVE OUTCOMES 234 Wendy O Kalberg and Julie Gelo 15. FETAL TERATOGEN SYNDROMES: PSYCHIATRIC ASPECTS AND MANAGEMENT 252 David J Bramble and Raja A S Mukherjee 16. RECOMMENDED MANAGEMENT OF COMMON MEDICAL PROBLEMS IN PREGNANCY: ADVICE FROM SPECIALIST AGENCIES 271 Evelyne Jacqz-Aigrain and Philip M Preece INDEX 280 COLOUR PLATE SECTION