Maternidad, infancia y drogas: implicaciones clínicas

Autores/as

  • Helena Calvo Botella Centro de Día PATIM. Psicóloga. Master en Prevención y Tratamiento de Conductas Adictivas. Enviar correspondencia a: Helena Calvo Botella. PATIM Plaza Tetuán 9, 3º CP 12001 Castellón.

DOI:

https://doi.org/10.20882/adicciones.395

Palabras clave:

mujer, droga, teratógeno, embarazo de alto riesgo, manifestaciones neuroconductuales

Resumen

Objetivos: Revisar la relación entre la exposición prenatal a drogas y el pronóstico fetal, neonatal e infantil. Material y métodos: se estudia el estado actual de la investigación relativa a la exposición prenatal a sustancias psicoactivas, mediante una extensa revisión de Medline y de las investigaciones de organismos norteamericanas y europeos durante los últimos años. Se presta especial atención a las dificultades metodológicas derivadas del objeto de estudio y a otros factores tales como la relación materno-infantil y las características de la mujer adicta. Resultados: la exposición prenatal a drogas se asocial a un amplio rango de complicaciones obstétricas y alteraciones neuroconductuales infantiles. Con la excepción del síndrome alcohólico fetal y otros efectos fetales ligados al alcohol, estas alteraciones suelen encontrarse en dominios cognitivos específicos y pueden estar moduladas por factores psicosociales y ambientales. Conclusiones: los niños expuestos prenatalmente a drogas pueden ser considerados un caso especial de infancia en riesgo. Es necesario investigar el impacto real de la exposición prenatal a sustancias psicoactivas y la relevancia de otros factores en su pronóstico a medio y largo plazo. Asimismo, es necesario implicar y formar a diferentes profesionales, tales como obstetras, ginecólogos y pediatras, y coordinar la intervención de las diferentes instituciones, para mejorar la atención prestada a la mujer drogodependiente y a sus hijos.

Citas

Coles CD. Critical periods for prenatal alcohol exposure: evidence from animal and human studies. Alcohol Health and Research World 1994; 18: 22-9.

Slotkin T. Fetal nicotine or cocaine exposure: which one is worse? J Pharmacol Exp Ther 1998; 285: 931-45.

Pérez Landeiro A, Allende-Bandrés MA, Agustín Fernández MJ, Palomo Palomo P. Teratogénesis: clasificaciones. Farm Hosp 2002; 26: 171-77.

Kosofsky BE. The effect of cocaine on developing human brain. En: Kilbey MM, Asghar K, editors. Methodological issues in controlled studies on effects of prenatal exposure to drug abuse. NIDA Research Monograph Nº 114. Rockville, MD: National Institute

of Drug Abuse, 1991. p 128-43.

Lester BM, LaGasse L, Freier K, Brunner S. Studies of cocaine-exposed human infants. In: Wetherington CL, Smeriglio VL, Finnegan LP, eds. Behavioral studies of drug-exposed offspring: methodological issues in human and animal research. NIDA Research

Monograph Nº 164. Rockville, MD: National Institute on Drug Abuse, 1996, p 175-210.

Brent RL. The application of the principles of toxicology and teratology in evaluating the risks of new drugs for treatment of drug addiction in women of reproductive age. In: Chiang CN, Finnegan LP, eds. Medications development for the treatment of pregnant addicts and their infants. NIDA Research Monograph Nº 149. Rockville, MD: National Institute on Drug Abuse, 1995. p 130-84.

Sokol RJ, Ager JW, Martier SS. Methodological issues in obtaining and managing substance abuse information from prenatal patients. In: Kilbey MM, Asghar K, eds. Methodological issues in epidemiological, prevention, and treatment research on drug-exposed women and their children. NIDA Research Monograph Nº 117. Rockville, MD: National Institute on Drug Abuse, 1992. p 80-97

Romera Modamio G, Fernández López A, Jordán García Y, Pastor Gómez A, Rodríguez Miguélez JM, Botet Mussons F, et al. Embriofetopatía alcohólica. Casuística neonatal propia en los últimos doce años. Anales Españoles de Pediatría 1997; 47:405-9.

Dow- Edwards D. Comparabilit y of human and animal studies of developmental cocaine exposure. In: Wetherington CL, Smeriglio VL, Finnegan LP, eds. Behavioral studies of drug-exposed offspring:

methodological issues in human and animal research. NIDA Research Monograph Nº 164. Rockville, MD; National Institute on Drug Abuse, 1996. p 146-74.

Maier SE, West JR. Drinking patterns and alcoholrelated birth-defects. Alcohol Res Health 2001; 25:168-74.

Abel EL. Effects of prenatal exposure to cannabinoids. In: Pinkert T, ed. Current research on the consequences of maternal drug abuse. NIDA Research Monograph Nº 59. Rockville, MD: National Institute on Drug Abuse, 1985. p 20-35.

Poch Olivé ML. Neurobiología del desarrollo temprano. Contextos Educativos 2001; 4: 79-94.

Herlenius E, Lagercrantz H. Neurotransmitters and neuromodulators during early human development. Early Hum Dev 2001; 65: 21-37.

Solís Sánchez G, Solís Sánchez JL, Díaz González T. Exposición prenatal a drogas y efectos en el neonato. Trastornos Adictivos 2001; 3: 256-62.

Spear LP. Assessment of the effects of developmental toxicants: pharmacological and stress vulnerability in offspring. In: Wetherington CL, Smeriglio VL, Finnegan LP, eds. Behavioral studies of drug-exposed offspring: methodological issues in human and animal research. NIDA Research Monograph Nº 164. Rockville, MD: National Institute on Drug Abuse, 1996.p 125-45.

Frank DA, Augustyn M, Knight WG, Pell T, Zuckermann B. Growth, development and behaviour in early childhood following prenatal cocaine exposure. A systematic review. JAMA 2001; 285: 1613-25.

Kwong TC, Ryan RM. Detection of intrauterine illicit drug exposure by newborn drug testing. Clin Chem 1997; 43: 235-42.

Singer LT, Arendt R, Minnes S, Salvator A, Siegel AC, Lewis BA. Developing language skills of cocaineexposed infants. Pediatrics 2001; 107: 1057-64.

Scher MS, Richardson GA , Day NL. Effects of prenatal cocaine/crack and other drugs exposure on electroencephalographic sleep studies at birth and one-year. Pediatrics 2000; 105: 39-48.

Handmaker NS, Wilbourne P. Motivational interventions in prenatal clinics. Alcohol Res Health 2001; 25: 219-29.

Coles CD. Discussion: measurement issues in the study of effects of substance abuse in pregnancy. In: Kilbey MM, Asghar K, eds. Methodological issues in epidemiological, prevention, and treatment research on drug-exposed women and their children. NIDA Research Monograph Nº 117. Rockville, MD: National Institute on Drug Abuse, 1992. p 248-58.

Martín Mandomingo MA, Solís Sánchez G, Málaga Guerrero S, Cuadrillero Quesada C, Pérez Méndez C, Matesanz Pérez JL. Consumo de drogas durante el embarazo y morbilidad neonatal : c ambios epidemiológicos en los últimos 10 años. An Pediatr 2003; 58: 574-9.

Chassnoff IJ. Methodological issues in studying cocaine use in pregnancy: a problem of definitions. In: Kilbey MM, Asghar K, eds. Methodological issues in controlled studies on effects of prenatal exposure to drug abuse NIDA Research Monograph Nº 114.

Rockville, MD: National Institute on Drug Abuse, 1991. p 55-65.

Bandstra ES. Assessing acute and long-term physica effects of in utero drug exposure on the perinate, infant, and child. In: Kilbey MM, Asghar K, eds. Methodological issues in epidemiological, prevention, and treatment research on drug-exposed women and their children. NIDA Research Monograph Nº 117. Rockville, MD: National Institute on Drug Abuse, 1992. p 212-27.

Mayes LC. Exposure to cocaine: behavioural outcomes in preschool and school-age children. In: Wetherington CL, Smeriglio VL, Finnegan LP, eds. Behavioral studies of drug-exposed offspring: methodological issues in human and animal research. NIDA Research

Monograph Nº 164.Rockville, MD: National Institute on Drug Abuse, 1996. p 211-29.

Jacobson JL, Jacobson SW. Assessment of teratogenic effects on cognitive and behavioural development in infancy and childhood. In: Kilbey MM, Asghar K, eds. Methodological issues in controlled studies on effects of prenatal exposure to drug abuse. NIDA Research Monograph Nº 114. Rockville, MD: National Institute on Drug Abuse, 1991. p 248-61.

Fried PA. Behavioral outcomes in preschool and school-age children exposed prenatally to marijuana: a review and speculative interpretation. In: Wetherington CL, Smeriglio VL, Finnegan LP, eds. Behavioral studies of drug-exposed offspring: methodological

issues in human and animal research. NIDA Research Monograph Nº 164. Rockville, MD: National Institute on Drug Abuse, 1996. p 242-60.

Hans SL. Prenatal drug exposure: behavioural functioning in late childhood and adolescence. In: Wetherington CL, Smeriglio VL, Finnegan LP, eds. Behavioral studies of drug-exposed offspring:

methodological issues in human and animal research. NIDA Research Monograph Nº 164. Rockville, MD: National Institute on Drug Abuse, 1996. p 262-76.

Warren KR, Foudin LL. Alcohol related birth defects: the past, present and future. Alcohol Res Health 2001; 25: 153-8.

Steinhausen H, Spohr HL. Long-term outcome of children with Fetal Alcohol Syndrome: psychopathology, behavior, and intelligence. Alcohol Clin Exp Res 1998; 22: 334-8.

Mattson S, Schoenfeld AM, Riley EP. Teratogenic effects of alcohol on brain and behavior. Alcohol Res Health, 2001; 25: 185-91.

Mattson SN, Goodman AN, Caine C, Delis DC, Riley EP. Executive functioning in children with heavy prenatal alcohol exposure. Alcohol Clin Exp Res 1999; 23: 1808-15.

Roebuck TM, Mattson SN, Riley EP. Behavioral and psychosocial profiles of alcohol-exposed children. Alcohol Clin Exp Res 1999; 23: 1070-6.

Kodituwakku PY, Kalberg W, May PA. The effects of prenatal alcohol exposure on executive functioning. Alcohol Res Health 2001; 25: 192-8.

Jacobson JL, Jacobson SW. Drinking moderately and pregnancy. Effects on child development. Alcohol Res Health 1999; 23: 25-30.

Coles CD, Platzman KA, Raskin-Hood CL, Brown RT, Falek A, Smith IE. A comparison of children affected by prenatal alcohol exposure and attention deficit, hyperactivity disorder. Alcohol Clin Exp Res 1997; 21 : 150-61.

Goodlett CR, Horn KH. Mechanisms of alcohol-induced damage to the developing nervous system. Alcohol Res Health 2001; 25: 175-84.

Committee on Drugs. Neonatal Drug Withdrawal. Pediatrics 1998; 101: 1079-88.

Bandstra ES, Morrow CE, Anthony JC, Churchill SS, Chitwood DC, Steele BW, et al. Intrauterine growth of full-term infants: impact of prenatal cocaine exposure. Pediatrics 200; 108: 1309-19.

Leza Cerro JC. Opiáceos ( III ) Tratamiento de la dep endencia c on ag onist as o piáceos. En Lorenzo P, Ladero JM, Leza JC, Lizasoain L, eds. Drogodependencias. Farmacología, patología,

psicología y legislación. Madrid: Editorial Médica Panamericana; 1999. p 77-86

Pastrakuljic A, Derewlany LO, Knie B, Koren G. The effects of cocaine and nicotine on amino acid transport across the human placental cotyledon perfused in vitro. J Pharmacol Exp Ther 2000; 294: 141 - 6.

Plessinger MA. Prenatal exposure to amphetamines: risks and adverse outcomes in pregnancy. Obst Gynecol Clin North Am 1998; 25: 119-38.

Dempsey DA, Hajnal BL, Partridge JC, Jacobson SN, Good W, Jones RT, et al. Tone abnormalities are associated with maternal cigarette smoking during pregnancy in in utero cocaine - exposed infants. Pediatrics 2000; 106: 79-85.

Napiorkowski B, Lester BM, Freier MC, Brunner S, Dietz L, Nadra A, et al. Effects of in utero substance exposure on infant neurobehavior. Pediatrics 1996; 98: 71-5.

Lidow M. Nonhuman primate model of the effect of prenatal cocaine exposure on cerebral cortical development. Ann N Y Acad Sci 1998; 846: 182-93.

Levitt P, Harvey JA, Friedman E, Simansky K, Murphy EH. New evidences for neurotransmitter influences on brain development. Trends Neurosci 1997; 20: 269-74.

Morrow BA, Elsworth JD, Roth RH. A xo -axonic structures in the medial prefrontal cortex of the rat: reduction by prenatal exposure to cocaine. J Neurosci 2003; 23: 5227-34.

Smith LM, Chang L, Yonekura ML, Gilbride K, Kuo J, Poland RE, et al. Brain proton magnetic resonance spectroscopy and imaging in children exposed to cocaine in utero. Pediatrics 2001; 107: 227-31.

Nulman I, Rovet J, Greenbaum R, Loebstein M, Wolpin J, Pace-Asciak P, et al. Neurodevelopment of adopted children exposed in utero to cocaine: the Toronto Adoption Study. Clin Invest Med 2001; 24: 129-37.

Potter SM, Zelazo PR, Stack DM, Papageorgiou A. Adverse effects of fetal cocaine exposure on neonatal auditory information processing. Pediatrics 2000; 105: e40. Disponible en: http://pediatrics.aappublications.org/cgi/reprint/105/3/e40 [consultado el 11/07/04].

Heffelfinger AK, Craft S, White DA, Shyken J. Visual attention in preschool children prenatally exposed to cocaine: implications for behavioral regulation. J Int Neuropsychol Soc 2002; 8:12-21.

Mayes LC, Grillon C, Granger R, Schottenfeld R. Regulation of arousal and attention in preschool children exposed to cocaine prenatally. Ann N Y Acad Sci. 1998; 846: 126-43.

Lester BM, Lagasse LL, Seifer R. Cocaine exposure and children: the meaning of subtle effects. Science 1998; 282: 633-4.

Mayes LC. A behavioral teratogenic model of the impact of prenatal cocaine exposure on arousal regulatory systems. Neurotoxicol Teratol 2002; 24:385-95.

Kaltenbach K A. Exposure to opiates: behavioural outcomes in preschool and school-age children. In: Wetherington CL, Smeriglio VL, Finnegan LP, eds. Behavioral studies of drug-exposed offspring: methodological issues in human and animal research. NIDA Research Monograph Nº 164. Rockville, MD:National Institute on Drug Abuse, 1996. p 230-41.

Schindler SD, Eder H, Ortner R, Rohrmeister K, Langer M, Fischer G. Neonatal outcome following buprenorphine maintenance during conception and throughout pregnancy. Addiction 2003; 98: 103-10.

S l o t k i n TA , S e i d l e r F J , Ya n a i J . H e r o i n neuroteratogenicit y: delayed - onset deficits in catecholaminergic synaptic activity. Brain Res 2003; 984 : 189-97.

Vathy I. Prenatal opiate exposure: long-term CNS consequences in the stress system of the offspring. sychoneuroendocrinology 2002; 27: 273-83.

Hans SL. Developmental consequences of prenatal exposure to methadone. Ann N Y Acad Sci 1989; 562:195-207.

Cornelius MD, Day NL. The effects of tobacco use during and after pregnancy on exposed children. Relevance of findings for alcohol research. Alcohol Res Health 2000; 24:242-49.

Ernst M, Moolchan ET, Robinson ML. Behavioral and neural consequences of prenatal exposure to nicotine. J Am Acad Child Adoles Psychiatry. 2001; 40: 630-41.

Werler MM. Teratogen update : smoking and reproductive outcomes. Teratology 1997; 55: 382–8.

Law KL, Stroud LR, LaGasse LL, Niaura R, Liu J, Lester BM. Smoking during pregnancy and newborn neurobehavior. Pediatrics 2003; 111: 1318-23.

Schoendorf KC, Kiely JL. Relationship of sudden infant death syndrome to maternal smoking during and after pregnancy. Pediatrics 1992; 90: 905-8.

Scher MS, Richardson GA , Robles N, Geva D, Goldschmidt L, Dahl RE, et al. Effects of prenatal substance exposure: altered maturation of Visual Evoked Potentials. Pediatr Neurol 1998; 18: 236-43.

Cornelius MD, Ryan CM, Day NL, Goldschmidt L , Willford JA . P renat al tob acco ef fec ts on neuropsychological outcomes among preadolescents. J Dev Behav Pediatr 2001; 22: 217-25.

Williams GM, O’Callaghan M, Najman JM, Bor W, Andersen MJ, Richards D, et al. Maternal cigarette smoking and child psychiatric morbidity: a longitudinal study. Pediatrics 1998; 102(1): e11. Disponible en: http://pediatrics.aappublications.org/cgi/reprint/102/1/e11 [consultado el 11/07/04].

Wakschlag LS, Lahey BB, Loeber R, Green SM, Gordon P.A, Leventhal BL. Maternal smoking during pregnancy and the risk of conduct disorder in boys. Arch Gen Psychiatry 1997; 54: 670-6.

Markussen Linnet K, Dalsgaard S, Obel C, Wisborg K, Henriksen TB, Rodriguez A , et al. Maternal lifestyle factors in pregnancy risk of Attention Deficit Hyperactivity Disorder and associated behaviors:

review of the current evidence. Am J Psychiatry 2003; 160: 1028 - 40.

Muneoka K, Nakatsu T, Fuji JI, Ogawa T, Takigawa M. Prenatal administration of nicotine results in dopaminergic alterations in the neocortex. Neurotoxicol Teratol 1999; 21: 603-9.

Roy TS, Sabherwal U. Effects of gestational nicotine exposure on hippocampal morphology. Neurotoxicol Teratol 1998; 20: 465-73.

Navarro M, Rubio P, de Fonseca FR. Behavioural consequences of maternal exposure to natural cannabinoids in rats. Psychopharmacology ( Berl) 1995; 122: 1-14.

Gotlib MS, Sassenrath EN, Chapman LF. Regulation of visual attention in offspring of female monkeys treated chronically with delta 9 -tetrahydrocannabinol. Dev Psychobiol. 1981; 14: 507-12.

Fernandez-Ruiz JJ, Berrendero F, Hernandez ML, Romero J, Ramos JA. The endogenous cannabinoid system and brain development. Trends Neurosci 2000; 23: 14-20.

Wang X , Dow- Edwards D, Keller E, Hurd Y L. Preferential limbic expression of the cannabinoid receptor mRNA in the human fetal brain. Neuroscience 2003; 118: 681-94.

Quiroga M. Cannabis: efectos nocivos sobre la salud física. Adicciones 2000; 12 Supl 2: 135-48.

Fried PA . Postnatal consequences of maternal marijuana use. In: Pinkert T, ed. Current research on the consequences of maternal drug abuse. NIDA Research Monograph Nº 59. Rockville, MD: National Institute on Drug Abuse, 1985. p 61-72.

Dahl RE, Scher MS, Williamson DE, Robles N, Day N. A longitudinal study of prenatal marijuana use. Effects on sleep and arousal at age 3 years. Arch Pediatrics Adolesc Med 1995; 149: 145-50.

Fried PA, Watkinson B, Gray R. Differential effects on cognitive functioning in 13- to 16-year-olds prenatally exposed to cigarettes and marihuana. Neurotoxicol Teratol 2003; 25: 427-36.

Fried PA , Smith AM. A literature review of the consequences of prenatal marihuana exposure. An emerging theme of a deficiency in aspects of executive function. Neurotoxicol Teratol 2001; 23: 1-11.

Koprich JB, Chen EY, Kanaan NM, Campbell NG, Kordower JH, Lipton JW. Prenatal 3,4-methylened ioxymethamphetamine (ecstasy) alters exploratory behaviour, reduces monoamine metabolism, and increases forebrain tyrosine hydroxylase fiber density of juvenile rats. Neurotoxicol Teratol 2003; 25: 509-17.

Broening HW, Morford LL, Inman-Wood SL, Fukumura M, Vorhees CV. 3,4 -methylenedioxymethamphe tamine (ecstasy) -induced learning and memory impairments depend on the age of exposure during early development. J Neurosci 2001; 21:3228-35.

Colado MI, O´Shea E, Granados R, Misra A, Murray TK, Green AR. A study of the neurotoxic effects of MDMA /”ecstasy”) on 5-HT neurones in the brains of mothers and neonates following administration of the drug during pregnancy. Br J Pharmacol 1997; 124:827-33.

Ho E, Karimi-Tabesh L, Koren G. Characteristics of pregnant women who use Ecstasy (3,4-methylenedio xymethamphetamine). Neurotoxicol Teratol 2001; 23:561-7.

McElhatton PR. The effects of benzodiazepine use during pregnancy and lactation. Reprod Toxicol 1994; 8: 461-75.

Laegreid L, Hagberg G, Lundberg A. Neurodevelopment i n l a te i n f a n c y a f te r p r e n a t a l ex p o s u r e to benzodiazepines: a prospective study. Neuropediatrics 1992; 23: 60-7.

Dolovitch LR, Addis A, Régis Vallancourt JM, Barry Power JD, Koren G, Einarson TR. Benzodiazepine use in pregnancy and major malformations or oral cleft: meta-analysis of cohort and case-control studies. BMJ 1998; 317 : 839–43.

González de Dios J, Moya-Benavetn M, Carratalá-Marco F. Floppy infant en gemelos por uso de benzodiacepinas durante la gestación. Rev Neurol 1999; 29: 121-3.

Bracken MB, Triche EW, Belanger K, Hellenbrand K, Leaderer BP. Association of maternal caffeine consumption with decrements in fetal growth. Am J Epidemiol. 2003; 157: 456-66.

Jones HE, Balster RL. Inhalant abuse in pregnancy. Obstet Gynecol Clin North Am 1998; 25: 153-67.

Pajulo M, Savonlahti S, Piha P. Maternal substance abuse: infant psychiatric interest: a review and a hypothetical model of interaction. Am J Drug Alcohol Abuse 1999; 25: 761- 9.

Beeghly M, Frank DA; Rose-Jacobs R, Cabral H, Tronick E. Level of prenatal cocaine exposure and infant-caregiver attachment behavior. Neurotoxicol Teratol 2003; 25: 23-38.

O´Connor MJ, Kogan N, Findlay R. Prenatal alcohol exposure and attachment behavior in children. Alcohol Clin Exp Res 2002; 26: 1592-1602.

Miller BA, Smyth NJ, Mudar PJ. Mothers’ alcohol and other drug problems and their punitiveness toward their children. J Stud Alcohol 1999; 60: 632-42.

Griffith DR, Freier C. Methodological issues in the assessment of the mother- child interactions of substance abusing women and their children. In: Kilbey MM, Asghar K (eds). Methodological issues in epidemiological, prevention, and treatment research on drug-exposed women and their children. NIDA Research Monograph Nº 117.Rockville, MD: National Institutes on Drug Abuse, 1992, p 228-47.

Kettinger LA, Nair P, Schuler ME. Exposure to environmental risk factors and parenting attitudes among substance-abusing women. Am J Drug Alcohol Abuse 2000; 26: 1-11.

Lang AR, Pelham WE, Atkenson BM, Murphy DA. Effects of alcohol intoxication on parenting behavior in interactions with child confederates exhibiting normal or deviant behaviors. J Abnorm Child Psychol 1999; 27: 177-89.

Nicholson J, Biebel K, Hinden B, Henry A, Stier L. Critical issues for parents with mental illness and their families. Rockville. Center for Mental Health Services Research. Department of Psychiatry. University of Massachusetts Medical School; 2001.

Nicholson J, Sweeney EM, Geller JL. Focus on women: mothers with mental illness I. The competing demands of parenting and living with mental illness. Psychiatr Serv 1998; 49: 635-42.

Nicholson J, Sweeney EM, Geller JL. Focus on women: mothers with mental illness II. Family relationships and the context of parenting. Psychiatr Serv 1998; 49:643-49.

Espinosa M, Beckwith L, Howard J, Tyler R, Swanson K. Maternal psychopathology and attachment in toddlers of heavy cocaine-using mothers. Infant Mental Health Journal 2001; 22: 316-33.

Weissman MM, McAvay G, Goldstein RB, Nunes E, Verdeli H, Wickramaratne P. Risk/protective factors among addicted mothers’ offspring: a replication study. Am J Drug Alcohol Abuse 1999; 25: 661-79.

Najavits LM, Weiss RD, Shaw SR. The link between substance abuse and posttraumatic stress disorder in women: a research review. Am J Addict 1997; 6: 273-83.

Stocco P. Nuevas perspectivas en la prevención e intervención sobre la mujer toxicómana en Europa. Ponencia presentada al I Symposium Nacional sobre Adicción en la Mujer. Fundación Instituto Spiral. Madrid, 6-7 de Octubre de 2000. Disponible en: http://www.

institutospiral.com / cursos%20y%20seminarios/primersymposium [consultado el 11/07/04].

Martin SL, Beaumont JL, Kupper LL. Substance use before and during pregnancy: links to intimate partner violence. Am J Drug Alcohol Abuse 2003; 29: 599-617.

Kauffmann J, Plotsky PM, Nemeroff CB, Charney D. Effects of early adverse experiences on brain structure and function: clinical implications. Biol Psychiatry 2000; 48: 778–90.

Spear LP, Campbell J, Snyder K, Silveri A, Katovic N. Animal behavior models. Increased sensitivity to stressors and other environmental experiences after prenatal cocaine exposure. Ann N Y Acad Sci 1998; 846: 76-88.

Woods JR. Clinical management of drug dependency in pregnancy. In: Chiang CN, Finnegan LP, eds. Medications development for the treatment of pregnant addicts and their infants. NIDA Research Monograph Nº 149. Rockville, MD: National Institutes on Drug Abuse, 1995. p 39-57.

Fischer G, Schmidl-Mohl K, Etzersdorfer P, Schatten C, Langer M, Weniger M, et al. Approaches to the management of pregnant drug misusers. In Pompidou Group (ed). Pregnancy and drug misuse: Proceedings. Symposium. Strasbourg, 6-7 March 1997. Strasbourg: Council of Europe Publishing, 1998. p 15-26.

Kumpfer KL. Links between prevention and treatment for drug-abusing women and their children. In: Wetherington CL, Roman AB, eds. Drug addiction research and the health of women. Rockville, MD: National Institute on Drug Abuse, 1998, p 417-38.

LLopis JJ. Sexuality and addiction. Implication in the woman drug addict. In: Stocco P, LLopis JJ, DeFazio L, Calafat A, Mendes F. Women drug abuse in Europe: gender identity. Venezia: IREFREA. 2000, p 39-44.

Seiden AM. Measures of pregnant, drug-abusing women for treatment research. In: Kilbey MM, Ashgar K, eds. Methodological issues in epidemiological, prevention, and treatment research on drug-exposed women and their children. NIDA Research Monograph

Nº 117. Rockville, MD: National Institutes on Drug Abuse, 1992. p 194-211.

Klee H. Health care delivery to drug using women during pregnancy and early motherhood. In Pompidou Group, ed. Pregnancy and drug misuse: Proceedings. Symposium. Strasbourg, 6-7 March 1997. Strasbourg: Council of Europe Publishing, 1998. p.27-41.

Llopis JJ, Rebollida M. Clínica de la mujer toxicómana. Un análisis de actitudes. Ponencia presentada al I Symposium Nacional sobre Adicción en la Mujer. Fundación Instituto Spiral. Madrid, 6-7 de Octubre de 2000. Disponible en: http://www.institutospiral.

com/cursos%20y%20seminarios/primersymposium [consultado el 11/07/04].

Rosenbaum M, Irwin K. Pregnancy, drugs, and harm reduction. In: Wetherington CL, Roman AB, eds. Drug addiction research and the health of women. Rockville, MD: National Institute on Drug Abuse, 1998. p 309-18.

Klee H. Health care deliver y during pregnancy: health professionals´ views. In Pompidou Group, ed. Pregnancy and drug misuse: Proceedings. Symposium organised by the Co-operation Group to Combat Drug Abuse and Illicit Trafficking in Drugs (Pompidou Group). Strasbourg, 6 -7 March 1997. Strasbourg:

Council of Europe Publishing, 1998. p 23-54.

Vulnerable people. Addicted mothers and their young children. Project supported by the European Comission. Bélgica 2001. Disponible en: http://www.vulnerablepeople.org/opmaak/manual.pdf [consultado el 11/07/04]

Paltrow LM. Punishing women for their behaviour during pregnancy: an approach that undermines the health of women and children. In: Wetherington CL, Roman AB (eds). Drug addiction research and the health of women. Rockville, MD: National Institute on Drug Abuse, 1998, p 467-501.

Howard J, Beckwith L. Issues in subject recruitment and retention with pregnant and parenting substanceabusing women. In: Rahdert ER, ed. Treatment for drug-exposed women and their children: advances in research methodology. NIDA Research Monograph Nº 166. Rockville, MD: National Institute on Drug Abuse, 1996. p 68-86.

Daley D, Gorske T. Improving treatment adherence for mothers with substance abuse problems. The Source. Newsletter of the National Abandoned Infants Assistance Resource Center 2000; 10: 1-5.

Becker J, Duffy C. Women drug users and drugs services provision: service -levels responses to engagement and retention. DPAS Paper 17. London: Report for the Home Office Drugs Safety Strategy Directorate, 2002.

Laudet A, Magura S, Furst RT, Kumar N, Whitney S. Male partners of substance-abusing women in treatment: an exploratory study. Am J Drug Alcohol Abuse 1999; 25: 607-27.

Sirvent C. Las dependencias relacionales ( D.R.): d e p e n d e n c i a e m o c i o n a l , c o d e p e n d e n c i a y bidependencia. Ponencia presentada al I Symposium Nacional sobre Adicción en la Mujer. Fundación Instituto Spiral. Madrid, 6 -7 de Octubre de 2000.

Disponible en: http: / /w w w.institutospiral.com/cursos%20 y%20 seminarios / primersymposium [consultado el 11/07/04].

Falkin GP, Strauss SM. Social supporters and drug use enablers: a dilemma for women in recovery. Addict Behav 2003; 28: 141-55.

Pinazi S, Ferrero C. Impacto psicosocial del acogimiento familiar en familia extensa: el caso de las abuelas y los abuelos acogedores. Rev Mult Geront 2003; 13: 89-101.

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2004-12-15

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