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Biomedical subjects

B Zuckerman

Publications and source records attributed to B Zuckerman.

At least 19 recordsLinked to original sources
PubMed1992

Psychosocial correlates of drug and heavy alcohol use among pregnant women at risk for drug use.

OBJECTIVE: To investigate the roles of life stress, depression, and social support in the use of drugs and alcohol among pregnant women at risk for substance use because they have a substance-using partner. METHODS: This is a secondary analysis of data collected for a study of the impact of health behaviors and psychosocial characteristics on the newborns of 1226 pregnant women. Participants were interviewed during pregnancy and postpartum using a questionnaire that included instruments such as the Life Experiences Survey, the Center for Epidemiologic Studies Depression Scale, and the Norbeck Social Support Questionnaire. Drug use by women was determined by self-report and urine toxicology screens. Drug use by partners was based on maternal report. RESULTS: Five hundred seventy-three women reported that they had a substance-using partner. These women were nearly five times more likely (odds ratio 4.87, 95% confidence interval 3.76-6.30) to be substance users compared with women who did not report substance use by a partner. Of these women, substance users reported more negative life events on average in the past year than did non-users (19.3 versus 15.8; P = .01). There was no difference in mean Center for Epidemiologic Studies Depression Scale scores (19.7 versus 18.7; P = .26) or in mean social support scores (78.2 versus 72.4; P = .14) between users and non-users. CONCLUSIONS: Women with substance-using partners have an increased likelihood of being users themselves. Among women with substance-using partners, substance use by a pregnant women is associated with more negative life events but not with depression symptomatology scores or social support scores.

Adult↗
PubMed1992

Reducing night waking in infancy: a primary care intervention.

Approximately 25% of infants wake regularly at night and need help in resettling. The purpose of this study was to implement and evaluate a brief intervention to prevent such night waking. The study used a prospective cohort design with historical controls. Information from the control group was collected at the 9-month visit. The intervention group was enrolled at the 4-month visit. The intervention consisted of information about sleep-onset associations, completion of a sleep chart, and discussion about sleep with the pediatrician. The outcome was also measured at the 9-month visit. To obscure the purpose of the study, the outcome questionnaire for both groups addressed feeding and sleeping. One hundred twenty-eight (74%) of 172 eligible infant-parent pairs comprised the control group and 164 (74%) of 222 the intervention group. The majority of families were white, married, and well-educated. The groups were similar with regard to sociodemographic variables and factors thought to be related to night waking such as current breast-feeding, thumb/pacifier sucking, maternal isolation, and parental perception of difficult child. At 9 months of age, the intervention infants were reported to experience 36% less night waking per week compared with those in the control group (2.5 vs 3.9 wakings per week, P = .02). Frequent night waking was twice as common in control infants (27% vs 14%, P = .01). It is concluded that this pediatric intervention can help parents reduce night waking in infants.

Cohort Studies↗
PubMed1991

A preliminary report of prenatal cocaine exposure and respiratory distress syndrome in premature infants.

A prospective study of maternal drug use during pregnancy and newborn outcomes provided us with an opportunity to assess the relationship between prenatal cocaine use and respiratory distress syndrome among premature infants. Women were consecutively recruited from the prenatal clinics at Boston (Mass) City Hospital between 1984 and 1988 and were interviewed during the prenatal and postpartum period by trained bilingual interviewers. Urine specimens were collected at the time of each interview and were analyzed for marijuana and cocaine metabolites. Following delivery, one of five pediatricians who were "blinded" to the mothers' prenatal and drug history performed a physical examination and abstracted medical information, including the diagnosis of respiratory distress syndrome from the medical record. The study sample consisted of 33 infants born at 34 weeks' or less gestation who were appropriate for gestational age and not exposed to heroin or methadone prenatally. Eight of the mothers of these 33 infants used cocaine prenatally. One (12%) of eight cocaine-exposed infants was diagnosed as having respiratory distress syndrome compared with 13 infants (56%) not exposed to cocaine prenatally. Infants not exposed had an odds ratio of 8.9 (95% confidence interval: 0.9, 83.5) for respiratory distress syndrome compared with infants exposed to cocaine prenatally. When the analysis was controlled for prolonged rupture of membranes, black race, infant gender, or gestational age, the adjusted odds ratio was essentially unchanged. This preliminary observation of a decreased incidence of respiratory distress syndrome among premature infants prenatally exposed to cocaine appears to be biologically plausible and needs to be confirmed in future studies with larger numbers of subjects to control for potentially confounding variables.

Adult↗
PubMed1991

Clinic-based intervention to promote literacy. A pilot study.

Educational research has shown that children become literate more easily if their parents read to them. A clinic-based program was designed to encourage early book use among parents of children at risk. It included (1) waiting room readers, (2) guidance about literacy development, and (3) provision of children's books at each visit. Seventy-nine parents of children aged 6 to 60 months were interviewed. Parents who had previously received a book were more likely to report looking at books with their children or that looking at books was a favorite activity (adjusted odds ratio, 4.05). This association was strongest among parents receiving Aid to Families With Dependent Children (odds ratio, 7.8). This preliminary study suggests that pediatricians can play a role in enriching children's early literacy environments, especially for children at high risk of school failure.

Aid to Families with Dependent Children↗
PubMed1991

Developmental and behavioral consequences of prenatal drug and alcohol exposure.

This article summarizes what is known about the effects of cocaine, opiates, marijuana, and alcohol on neonatal and postnatal growth and development. The development of a child affected by prenatal exposure to drugs and alcohol is best understood through a multifactorial model consisting of interrelated prenatal and postnatal factors. The article also describes the prenatal effects of drugs and alcohol on the newborn, especially on central nervous system functioning, which is seen as creating a biologic vulnerability that renders a child more vulnerable to the effects of poor caretaking.

Alcoholism↗
PubMed1991

Circulating catecholamine concentrations in cocaine-exposed neonates: a pilot study.

Twenty newborns, 12 with prenatal exposure to cocaine and an unexposed control group of 8, were studied to determine concentrations of circulating catecholamines and their relationship to newborn behavior. Birth weight of the cocaine-exposed neonates was significantly lower than that of the control group. Gestational age, length, and head circumference of the cocaine-exposed neonates were also lower, although the differences did not reach statistical significance. Between 24 and 48 hours of age, circulating concentrations of norepinephrine, dopamine, and the catecholamine precursor dihydroxyphenylalanine were measured and behavior was assessed using the Neonatal Behavioral Assessment Scale. Mean dihydroxyphenylalanine concentrations were increased in the cocaine-exposed newborns (10.3 ng/mL vs 5.9 ng/mL, P = .055), while there was no difference between the groups in mean norepinephrine or dopamine concentrations. There was a significant negative correlation between norepinephrine concentration and orientation cluster score for the cocaine-exposed newborns (r2 = .6979, P = .005). norepinephrine concentration did not correlate with the score for any other behavioral cluster, nor did dopamine or dihydroxyphenylalanine concentration correlate with the score for any cluster. These preliminary data from a pilot study suggest that catecholamine activity is increased in cocaine-exposed newborns and may play a role in neurobehavioral disturbances associated with prenatal exposure to this drug.

Birth Weight↗
PubMed1991

Night waking during infancy: role of parental presence at bedtime.

Night waking occurs commonly in infants and young children. The goal of this study is to determine whether parents who report being present when their infant falls asleep at bedtime are more likely to report increased frequency of night waking by the infant. Mothers were consecutively recruited when they brought their infants to the clinic for their 9-month well-child visit. A total of 122 mothers agreed to participate and completed a questionnaire consisting of closed-ended, forced choice questions about their infant's feeding and sleeping behavior, and demographic and psychosocial characteristics. For 33% of the mothers, a parent was routinely present when the infant went to sleep. The entire sample of infants averaged 4.1 night wakings during the week prior to questionnaire completion. Infants whose parents were present at bedtime were significantly more likely to wake at night than infants whose parents were not present (6.2 vs 3.1, P = .01). Frequent night waking (seven or more wakings in the prior week) occurred in 28% of the sample. More of the infants whose parents were present experienced frequent night waking compared with infants whose parents were not present (40% vs 22%, P less than .04). When potential confounding variables were controlled by multivariate analysis, parents being present when the child went to sleep was independently associated with night waking (P less than .03). The association of parental presence at bedtime and night waking has implications for preventing and managing disruptive night waking in infancy.

Behavior↗
PubMed1991

Psychosocial correlates of severe temper tantrums.

Temper tantrums are common and distressing, but little epidemiological information is available about them. Attempts to identify psychosocial correlates of tantrums have used small samples and have not controlled for multiple concurrent behavior problems. We analyzed interviews from 502 English mothers of 3-year-olds. Tantrums were considered present if mothers reported tantrums three or more times a day or lasting 15 minutes or longer. Behavior problems were assessed using the Behavior Screening Questionnaire. Tantrums were reported in 6.8% of children, of whom 52% had multiple behavior problems. Factors independently associated with tantrums included maternal depression and irritability, low education, and use of corporal punishment, manual social class, marital stress, child care provided exclusively by the mother, and poor child health. Tantrums were not associated (at p less than 0.01) with gender, maternal employment, low social support, or single parenthood. Severe tantrums may indicate the presence of multiple behavior problems and psychosocial stressors.

Child Behavior Disorders↗
PubMed1990

Pediatrician's knowledge and practices regarding parental use of alcohol.

Problems with alcohol are common in the United States but are too frequently ignored by physicians, particularly those working with children. We explored pediatricians' knowledge and practices regarding parental use of alcohol and compared these attributes with those of family practitioners. Child health care providers attending three continuing medical education courses in general pediatrics were surveyed using a closed-item questionnaire. One hundred ninety (69%) of the participants responded, including 90 pediatricians and 39 family practitioners. Forty-six percent of responding pediatricians, compared with 90% of family practitioners, stated that they ask about problems with alcohol in taking a routine family history. Thirty-eight percent of pediatricians who knew the frequency of alcoholism, compared with 47% of those who did not, indicated that they include it in taking a routine family history. Forty-six percent of pediatricians who have experienced a problem with alcohol in their own family, compared with 20% of pediatricians without such personal experience, routinely address the issue of alcohol use with parents and children. Similar analyses among the family practitioners revealed no significant differences. We conclude that fewer than half of pediatricians ask about problems with alcohol in taking a family history. The likelihood of asking about such problems was not influenced by the health care provider's knowledge of alcoholism, but it was influenced by the provider's personal family history of problems with alcohol. Because of the important morbidity associated with alcohol use in families, and because intervention can improve functioning and adaptation of the child, training and Continuing Medical Education courses should address this issue.

Alcoholism↗
PubMed1990

Neonatal body proportionality and body composition after in utero exposure to cocaine and marijuana.

The relationship of maternal use of marijuana and cocaine during pregnancy to measures of neonatal body proportionality and body composition was assessed in a multiethnic sample of 1082 newborn infants. Maternal use of marijuana and cocaine during pregnancy was ascertained by self-report and by an enzyme-multiplied immunoassay technique for screening of urine samples obtained prenatally and again post partum. After each substance was analytically controlled for use of the other and for other potentially confounding variables, detection of marijuana metabolites in maternal urine was associated (p less than 0.05) with depressed mean arm muscle circumference and nonfat area of the arm but not with any measure of neonatal fatness. In contrast, detection of cocaine in maternal urine was associated (p less than 0.05) with decrements of subscapular fat folds and of the fat and nonfat areas of the arm. Although both substances were associated with depressed birth weight, there was no decrement of neonatal ponderal index or of the arm circumference/head circumference ratio in association with exposure to either substance. We conclude that both marijuana exposure and cocaine exposure during pregnancy are associated with symmetric intrauterine growth retardation, but that deficits are in differing compartments of intrauterine growth. These findings suggest that marijuana may retard fetal growth through maternal-fetal hypoxia, whereas cocaine may alter nutrient transfer to the fetus and fetal metabolism.

Adipose Tissue↗