1473 ABNORMAL CARDIORESPIROGRAPHIC (CRG) TRACINGS AND ELEVATED SERUM CREATINE PHOSPHOKINASE (CPK) IN INFANTS OF DRDG DEPENDENT MOTHERS. (IDDM)

Abstract

Continuous respiratory & heart rate monitoring were done during the first 5 postnatal days in 12 IDDM & 19 normal infants (control). The results showed abnormal CRG patterns in the IDDM such as: (1) significantly (p<0.01) higher baseline heart rate. (BHR), beat to beat (BBV) & long term (LTV) variability, and resp. rate (RR) - See Table, (2) exaggerated response of HR to stimuli such as light, noise or pain, and (3) frequent & spontaneous occurences of large (Δ40 bpm), brief, rise and fall in HR giving a characteristic “wave-like” appearance to the tracings. The BBV & LTV changes were also more intense (p<0.02) in the IDDM with moderate to severe, as compared to mild withdrawal. Treatment of the withdrawal with drugs, did not abolish the CRG abnormalities despite distinct clinical improvement. Serum CPK (normal = 80 - 450 IU/L) was also analyzed in 16 IDDM during the first 2-7 days of life. Eleven infants (69%) had markedly elevated CPK levels (Mean = 1313 ± 401 IU/L; range = 459 - 5123), & predominantly of the MM fraction (89%). The elevated CPK did not correlate with the infant's birth weight, GA or Apgar score, but was usually found in the infants with significant tremors & hypertonicity. Conclusion: The chronic exposure of infants to drugs of abuse, in utero, induces striking changes in their CRG patterns postnatally & elevation of their serum CPK isoenzymes. These new findings may provide a probe which can be used to study this group of infants, ante-natally & postnatally.