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Dos Santos JF, de Melo Bastos Cavalcante C, Barbosa FT, Gitaí DLG, Duzzioni M, Tilelli CQ, Shetty AK, de Castro OW. Maternal, fetal and neonatal consequences associated with the use of crack cocaine during the gestational period: a systematic review and meta-analysis. Arch Gynecol Obstet 2018; 298:487-503. [PMID: 29951712 DOI: 10.1007/s00404-018-4833-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 06/13/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Crack cocaine consumption is one of the main public health challenges with a growing number of children intoxicated by crack cocaine during the gestational period. The primary goal is to evaluate the accumulating findings and to provide an updated perspective on this field of research. METHODS Meta-analyses were performed using the random effects model, odds ratio (OR) for categorical variables and mean difference for continuous variables. Statistical heterogeneity was assessed using the I-squared statistic and risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale. Ten studies met eligibility criteria and were used for data extraction. RESULTS The crack cocaine use during pregnancy was associated with significantly higher odds of preterm delivery [odds ratio (OR), 2.22; 95% confidence interval (CI), 1.59-3.10], placental displacement (OR, 2.03; 95% CI 1.66-2.48), reduced head circumference (- 1.65 cm; 95% CI - 3.12 to - 0.19), small for gestational age (SGA) (OR, 4.00; 95% CI 1.74-9.18) and low birth weight (LBW) (OR, 2.80; 95% CI 2.39-3.27). CONCLUSION This analysis provides clear evidence that crack cocaine contributes to adverse perinatal outcomes. The exposure of maternal or prenatal crack cocaine is pointedly linked to LBW, preterm delivery, placental displacement and smaller head circumference.
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Affiliation(s)
- Jucilene Freitas Dos Santos
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP 57072-970, Brazil
| | - Cibelle de Melo Bastos Cavalcante
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP 57072-970, Brazil
| | - Fabiano Timbó Barbosa
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP 57072-970, Brazil
| | - Daniel Leite Góes Gitaí
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP 57072-970, Brazil
| | - Marcelo Duzzioni
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP 57072-970, Brazil
| | - Cristiane Queixa Tilelli
- Central-West Campus Dona Lindu, Federal University of São João del-Rei (UFSJ), Divinópolis, MG, Brazil
| | - Ashok K Shetty
- Department of Molecular and Cellular Medicine, Institute for Regenerative Medicine, Texas A&M Health Science Center College of Medicine, College Station, TX, USA
| | - Olagide Wagner de Castro
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP 57072-970, Brazil.
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Kopetz CE, Woerner JI, Briskin JL. Another look at impulsivity: Could impulsive behavior be strategic? SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2018; 12:e12385. [PMID: 34079587 PMCID: PMC8168538 DOI: 10.1111/spc3.12385] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
In the present article, we propose that impulsive behavior may be a response to certain needs or goals that people have in the moment and could therefore be strategic. We review briefly the dominant approaches and findings in the impulsivity literature. We then examine different behaviors that are typically considered impulsive such as delay discounting, risky sexual behavior, risk taking in the context of emotion dysregulation, and adolescent risk behavior and present evidence suggesting that they follow the general principles of goal pursuit. Specifically, they are (a) enacted when perceived as relevant to the individual's motivation; (b) less likely when alternative means to fulfill these goals are available; and (c) supported rather than reduced by sufficient executive control, a hallmark of goal pursuit. We do not argue that there is no impulsive behavior. Rather, we suggest that such behavior may represent individuals' attempts to fulfill current motivations or needs. This approach emphasizes the functionality and dynamism of the behavior, it provides a framework to explain the inconsistencies in the literature, it helps us to move away from pathologizing or moralizing the behavior, and it provides insights about potential strategies to mitigate the negative consequences of acting impulsively.
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