Non-invasive Evaluation of Neonatal Cerebral Status in the Newborns of Mothers Addicted to Alcohol and Drugs

The present study aims to assess the effects of alcohol and drug consumption on the cerebral status of a newborn with risk. Although there is a vast literature on the quality of life in terms of health, there is no uniform point of view, since the well-being of a person implies other elements that consider not only health but also the economic and educational environment in which the individual evolves and often these factors are connected. Besides, there is no valid instrument for measuring the quality of life either for an adult or for a child. In most cases, alcohol consumption intensifies in time, significantly decresing the quality of life for the mother and especially for the conception product. The study focuses on showing the The study focuses on highlighting the psychosocial and pharmacological aspects relevant to the diagnosis and management of neonatal cerebral status. The study participants, whose responses were the base for the quantitative analyzes, were individually interviewed using a standardized interview protocol. The interviews were conducted between October 2015 and September 2017. The interview protocol included three sections, in this chapter focusing our attention on the following sections: a) socio-demographic characteristics: age of gestation, sex of the newborn; b) clinical data: Presentation, Weight at Birth, Apgar Score, Cerebral Saturation (rSO2), Peripheral saturation (SpO2), The extraction fraction (FTOE), Parameters harvested from the umbilical cord at birth (pH, Base excess (BE), pCO2, pO2, MetHb, COHb), c) risk profile: mother�s alcohol consumption, including during pregnancy and drug use. The study group consisted of 90 infants born full term in Elena Doamna Maternity Hospital in Iasi, between 2015-2017, included in the programme of follow-up of the newborn with risk with the purpose of performing an non-invasive assessment of the fetal and neonatal cerebral status, in order to prevent and establish treatment methods for perinatal asphyxia. Based on the information obtained through the preliminary documentation, 30 newborns with alcohol and / or drug-consuming mothers and 60 neonates with risk-free mothers were selected - the control batch, who accepted to participate in the study.The cases studied showed the homogeneity of the groups depending on the mother�s age and gestational age, as well as the sex of the newborn and the weight at birth (p]0.05). In neonates from mothers at risk, the under-reference level of 1-minute brain saturation, combined with a lower gestational age and the 62.5% probability of performing a caesarean section at low levels of cerebral saturation was noted in 66.7% of newborns.The cut off value of SpO2, was established at 70 mL/ 100g/1 min, with a sensitivity of 50.9% and a specificity of 51.3%, after reading the coordinates of ROC curve, but the prediction was not significant from the statistical point of view (p=0.670). The mean level of base excess was al excesului de baze was slightly lower in newborns with the extraction fraction below the cut off value (-4.64 vs -4.18; p=0.560). According to the cases studied, 1 min after birth, 23.3% of the newborns showed an increased level of pCO2 associated with a reduced level of peripheral saturation (r= -0.231; p=0.05). The correlation between the pO2 level and the cerebral saturation, recorded 1 min after birth, was direct, but reduced as intensity (r= +0.295; p=0.049). About 27% of the newborns associated increased values of pO2 with reduced values of the extraction fraction (r=-0.272; p=0.047). The newborns with an extraction fraction over the cut off value had a level of COHb below 1% (p=0.756) more frequently. Newborns from mothers who have consumed alcohol and / or drugs, including during pregnancy, show a reduced level of cerebral saturation and peripheral saturation 1 minute after birth. In 16.7% of newborns, the extraction limit was below the baseline 1 minute after birth.