Maternal substance use during pregnancy and developmental outcome at age three

At the Tip of an Iceberg: Prenatal Marijuana and Its Possible Relation to Neuropsychiatric Outcome in the Offspring

“…Some human longitudinal studies on Caucasian and African-American women suggest that prenatal marijuana and alcohol are independent predictors of academic child performance (96,118). Yet another study warns that individual effects of substance use, particularly of "subtle ones" during pregnancy, might not be detected in smaller populations, precluding interaction analysis (129). Similarly, cocaine is co-abused with marijuana (up to 44% in specific socioeconomic cohorts) (121), but longitudinal follow-up of affected offspring is insufficient to justify the interaction of these substances.…”

Fetal Alcohol and Drug Effects

“…15 Other behaviors described in preschoolers related to maternal drinking during pregnancy include higher activity level, greater difficulty in following instructions, temper tantrums, eating problems, and eating nonfood. 16 Heavy alcohol exposure prenatally, but not mild or moderate exposure, has been linked to a decrease in IQ scores of about 5 to 7 points 17 ; hyperactive behavior; attentional problems; and abnormalities in executive function (i.e., organizing and planning). 18 -20 Advanced maternal age confers offspring with greater vulnerability to alcohol effects; compared with younger drinking mothers, older alcohol-drinking mothers (Ͼ30 years) were 2 to 5 times more likely to have offspring that were functionally impaired, 21 an effect felt to be independent of maternal parity.…”

“…35 This effect may help explain the behavioral abnormalities found among offspring of smokers. For instance, controlled studies have reported higher rates of externalizing behaviors (i.e., aggressive and delinquent behavior) 36,37 and increased deficits in attention and activity level among offspring 16,38 of smokers. Exposure to 20 cigarettes per day was associated with a 2.6 increased odds of externalizing behaviors, suggesting a dose-response effect.…”

“…44 At age 3 years maternal marijuana use during pregnancy was associated with increased fearfulness, poorer motor skills, and shorter length of play. 16 Marijuana exposure via maternal breast milk in the first postpartum month was noted at age 12 months to have a negative effect on motor but not mental development. 48 The mechanism by which marijuana exerts its effects is unknown.…”

Conditional likelihood estimation and efficiency comparisons in proportional odds model with missing covariates

“…Several models for analyzing data with ordinal responses have been proposed in the literature, such as the cumulative logit or proportional odds model (Walker and Duncan 1967;McCullagh 1980), the constrained and unconstrained partial proportional odds model (Peterson and Harrell 1990) and the adjacent-category logistic model (Agresti 1984). The proportional odds model has been extensively used in medical studies for analyzing data with ordered categorical outcomes (see Ashby et al 1989;McCusker et al 1994;Faden andGraubard 2000 andManor et al 2000).…”