Intrauterine Cocaine Effects on Neonatal Middle Cerebral Artery (MCA) Blood Flow Velocity (BFV)

Abstract 1330 Poster Session IV, Tuesday, 5/4 (poster 272) CNS midline defects, brain hemorrhages and microcephaly have been demonstrated in infants of mothers with a history of cocaine addiction. These findings are considered related to the widely recognized vasoconstriction as a pharmacological effect of cocaine. In animal studies, cocaine has been shown to alter cerebral blood flow. To our knowledge, such an effect has not been shown in newborn infants. We hypothesized that intrauterine exposure to cocaine will decrease blood flow velocity of the middle cerebral artery (MCA.) Study group consisted of 11 newborns whose urine screens were positive for cocaine metabolites with 11 non-exposed infants serving as controls. Doppler studies of MCA were performed in all infants between 4 and 48 hours of life. BFV and cardiac output (C.O.) were measured. Relative vascular resistance (VR) was calculated by using the ratio of mean arterial blood pressure (MAP) to mean BFV (Vmean). Results: Mean ± SD (Table) Mean blood flow velocity (p< 0.38) and relative vascular resistance (p< 0.74), showed no statistical differences between the two groups. Likewise, mean arterial pressures (p< 0.28) and cardiac output (p< 0.2), were not significantly different between cocaine and control groups. We conclude that, in contrast to animal studies showing cerebral blood flow changes secondary to cocaine, there was no demonstrable effect on BFV of MCA in these newborn infants in the first 48 hours of life.