Necrotizing enterocolitis has been linked to prenatal cocaine exposure. We hypothesized that intrauterine cocaine exposure causes intestinal circulatory impairment in the neonate. Doppler SMA blood flow velocity (BFV) and cardiac output (CO) were recorded in 8 newborn infants whose urine screens were positive for cocaine metabolites and in 7 non-exposed healthy infants before and after a milk feeding. All examinations were performed between 12-48 hours of age. Results: data in Mean±SD, Table

Table 1 No caption available.
Full size table

The prefeed mean BFV (Vmean) of cocaine infants did not differ from control, however the postprandial response was significantly less compared to control (p<0.016). The postprandial increase in Vmean of cocaine infants did not reach statistical significance, contrasting with that of the control group which demonstrated a 65% increment (p<0.0002). There were no changes in heart rate and cardiac output after feeding. These findings showed that antenatal cocaine exposure did not affect prefeed intestinal blood flow velocity in the newborn but it blunted the postprandial response to a physiologic stimulus such as feeding. We suggest that the functional capacity of the intestinal circulation is disturbed by sustained cocaine induced vasoconstriction in-utero. This may place the infant at risk for necrotizing enterocolitis.