Maternal cocaine use and mother–infant interactions: Direct and moderated associations

Abstract

This study examined the associations between prenatal cocaine exposure and quality of mother-infant play interactions at 13 months of infant ages. We investigated whether maternal psychological distress and infant reactivity mediated or moderated this association. Participants consisted of 220 (119 cocaine exposed, 101 non-cocaine exposed) mother-infant dyads participating in an ongoing longitudinal study of prenatal cocaine exposure. Results indicated that mothers who used cocaine during pregnancy displayed higher negative affect and lower sensitivity toward their infant during play interactions at 13 months, and that their infants were less responsive toward them. Contrary to hypothesis, this association was not mediated by maternal psychological distress or by infant reactivity. However, results for both the cocaine and non-cocaine exposed infants were supportive of a transactional model where lower maternal sensitivity at 1 month was predictive of higher infant reactivity at 7 months, which in turn was predictive of lower maternal warmth/sensitivity at 13 months, controlling for potential stability in maternal behavior. Results also indicated that as hypothesized, infant reactivity moderated the association between maternal cocaine use during pregnancy and maternal warmth/sensitivity at 13 months of age. Cocaine using mothers who experienced their infants as being more reactive in early infancy were less warm/sensitive toward them in later infancy. Results have implications for parenting interventions that may be targeted toward improving maternal sensitivity among cocaine using mothers with more reactive infants.

Prenatal cocaine effects on brain structure in early infancy

“…Since it is neither ethical nor possible to randomize human subjects to drug use groups, or to limit drug use to cocaine or any other single drug, this heterogeneity is unavoidable and reflects drug use in the community. Mothers in the PCE group smoked more cigarettes per day during pregnancy, however in contrast to some studies (Singer et al 2005; Eiden et al 2011), rates of prenatal use of other drugs (alcohol, marijuana, opiates) were not greater in PCE than NCOC groups, and significant differences in brain structure were retained after adding the number of other drugs used to statistical models.…”

“…Nevertheless some studies report no observable PCE effects (Frank et al 2001). Others reveal independent or interactive effects with nicotine, alcohol, or contextual factors (prematurity, gender, maternal care, environmental characteristics (Bandstra et al 2010; Eiden et al 2011; Irner 2012; Liu et al 2013). The purpose of the current study was to examine the effects of prenatal cocaine exposure on infant brain structure during early infancy, at a time more proximal to in utero exposure, and less influenced by the postnatal environment.…”

Prenatal cocaine exposure: The role of cumulative environmental risk and maternal harshness in the development of child internalizing behavior problems in kindergarten

“…Thus, a total of 275 women were excluded based on these two criteria. Details regarding number of women screened and eligible have been reported in prior publications (e.g., Eiden, Schuetze, & Coles, 2011). …”

The effect of prenatal substance use and maternal contingent responsiveness on infant affect

“…In another study, toddlers prenatally exposed to polysubstance use were found to have adverse outcomes, such as lower self-regulation and increased externalizing problems at 3 years of age, when their mothers were observed using harsh behaviors during a video-taped free play paradigm (20). Heightened infant reactivity and distress, mother-infant attachment disorders, and decreased sensitivity and responsiveness towards the child have been associated in research with parenting practices among mothers with various substance use disorders (21–26). Substance-using mothers of children with prenatal exposures have been shown to perform poorer than non-using caregivers of children with prenatal exposures on caregiver-child interaction assessments, highlighting the particular vulnerability of the maternal-child relationship when maternal substance use is present (27).…”