New evidence for neurobehavioral effects of in utero cocaine exposure

Jacobson, Sandra W.; Jacobson, Joseph L.; Sokol, Robert J.; Martier, Susan S.; Chiodo, Lisa M.

doi:10.1016/s0022-3476(96)70124-5

Cited by 182 publications

(141 citation statements)

References 67 publications

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“…The poorer novelty preferences of the heavily cocaine-exposed group in the present study are consistent with the lower visual recognition memory performance scores noted in heavily cocaine-exposed infants at 6 1/2 and 12 months of age in prior studies (Jacobson et al, 1996;Struthers & Hansen, 1992). In the perinatal period, other investigators have found cocaine-exposed neonates to demonstrate poorer habituation (which includes reaction to the repeated presentation of a visual stimulus) on the NBAS (Eisen et al, 1991;Mayes et al, 1993), poorer orientation (Mirochnick et al, 1997;Delaney-Black et al, 1996), and to demonstrate deficits in arousal-modulated attention similar to those noted in neonates with central nervous system compromise (Gardner, Karmel, & Magnano, 1992).…”

Section: Discussionsupporting

confidence: 92%

“…Cocaine exposure, however, was confounded with exposure to other illicit drugs and alcohol in addition to cocaine. In a large, well controlled study, Jacobson and colleagues (Jacobson, Jacobson, Sokol, Martier, & Chiodo, 1996) tested non-cocaine exposed and cocaine-exposed infants at 6.5 and 12 months corrected ages, and found that infants with history of heavy cocaine exposure, even after accounting for the effects of other drugs, had poorer recognition memory performance on the Fagan Test, while lightly exposed infants were comparable to non-exposed controls. These studies suggest that in utero cocaine exposure may affect infant visual selectivity and cognitive development.…”

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confidence: 99%

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Neonatal visual information processing in cocaine-exposed and non-exposed infants

Singer

Arendt

Fagan

et al. 1999

Infant Behavior and Development

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This study investigated early neonatal visual preferences in 267 poly drug exposed neonates (131 cocaine-exposed and 136 non-cocaine exposed) whose drug exposure was documented through interviews and urine and meconium drug screens. Infants were given four visual recognition memory tasks comparing looking time to familiarized stimuli of lattices and rectangular shapes to novel stimuli of a schematic face and curved hourglass and bull's eye forms. Cocaine-exposed infants performed more poorly, after consideration of confounding factors, with a relationship of severity of cocaine exposure to lower novelty score found for both self-report and biologic measures of exposure, Findings support theories which link prenatal cocaine exposure to deficits in information processing entailing attentional and arousal organizational systems. Neonatal visual discrimination and attention tasks should be further explored as potentially sensitive behavioral indicators of teratologic effects. Keywordscocaine; neonatal visual attention; information processing; marijuana; alcohol poly drug exposure; visual recognition memory Over the past decade, prenatal cocaine exposure has emerged as a significant public health problem, affecting 5-15% of infants in urban areas of the United States. There is concern and controversy over cocaine's teratogenic potential since cocaine easily crosses the placental barrier during gestation (Woods, Plessinger, & Clark, 1987). This transmission of cocaine may directly and indirectly affect the fetus. Cocaine's stimulant effects on several neurotransmitter systems in adults have been noted (Wise, 1984), as cocaine prevents the reuptake of catecholamine presynaptically and has been found to affect primarily the cardiovascular, respiratory, and central nervous systems.There are a number of different mechanisms by which prenatal cocaine exposure could affect fetal development (Volpe, 1992). Alterations in catecholamine levels during gestation may affect the maturation of fetal neurotransmitter systems (Tennyson, Gershon, Budinkas, Copyright © 1999 Elsevier Science Inc.• Lynn T. Singer, The Triangle Building, 11400 Euclid Avenue, Suite 250-A, Cleveland, Ohio 44106; Phone: (216) Fax: (216) & Rothman, 1983;Wang & Schnoll, 1986). Animal studies have found that prenatal cocaine exposure is associated with increased catecholaminergic fiber densities in selected brain areas such as the posterior parietal cortex (Akbari & Azmitra, 1992;Posner & Peterson, 1988). Cocaine exposure may affect fetal brain development through its release and metabolism of monoamines, which are important in the definition of fetal brain structure and neuronal formation . In addition, the reduction of blood flow prenatally to cocaine-exposed fetuses may affect later infant information processing or problem solving .The early behavioral development of cocaine-exposed infants has been studied using measures of sensory-motor processing such as the Brazelton Neonatal Behavioral Assessment Scale (NBAS), (Brazelton, 1984) neonatall...

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%

Neonatal visual information processing in cocaine-exposed and non-exposed infants

Singer

Arendt

Fagan

et al. 1999

Infant Behavior and Development

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“…The researchers concluded that impairments in initial reactivity and selectivity toward novel stimuli may exist in a select sub-group of cocaine-exposed infants, such as infants exposed to a high level of cocaine. Findings of S. W. Jacobson, J. L. Jacobson, Sokol, Martier, and Chiodo (1996) supported the hypothesis that heavy but not light cocaine exposure is more likely to have negative consequences. They found that heavy cocaine exposure was related to poorer recognition memory and information processing than was light or no cocaine exposure.…”

mentioning

confidence: 72%

Cognitive functioning in 8- to 18-month old drug-exposed infants.

Alessandri¹,

Bendersky²,

Lewis³

1998

Developmental Psychology

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This study examined the cognitive functioning in 236 infants at 8 and 18 months of age. Thirty-seven infants were heavily exposed to cocaine in-utero, 30 were lightly exposed, and 169 were not exposed to cocaine. Cognitive functioning was evaluated with the Bayley Scales of Infant Development (2nd ed.; N. Bayley, 1993) at both ages. Infant information processing was also assessed with an infantcontrolled habituation procedure. Results indicated that (a) infants of cocaine-abusing women had higher neonatal medical and environmental risk scores; (b) at 8 months, exposure groups did not differ in Psychomotor Development Index, Mental Development Index (MDI) scores, or recovery to a novel stimulus; and (c) infants heavily exposed to cocaine or high environmental risk had a decrease in MDI scores from 8 to 18 months. These results were obtained when neonatal medical and environmental risk, as well as polydrug exposure, were controlled.In examining whether prenatal exposure to cocaine impairs later cognitive functioning, research on humans continues to provide equivocal results. The ambiguous nature of outcome findings is due to methodological problems typically associated with behavioral toxicology research. In studies in which researchers are attempting to find relations between prenatal cocaine and some aspect of postnatal development, researchers must contend with a host of methodological problems, including (a) the potential confounding effects of other substances of abuse and poor maternal health and nutrition, (b) sensitive and valid measurement of infant outcome behaviors, and (c) differential effects of the postnatal child-rearing environment (e.g.,

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“…Because of concerns for the safety our staff in carrying out home visits, we administered a version of the HOME scale (36) that was modified for use in the office following recommendations by Jacobson et al (37). The modified HOME scale entailed devising a scripted conversation to cover mother-child activities but omitted items that require direct observation (e.g.…”

Section: Methodsmentioning

confidence: 99%