Pre-natal exposures to cocaine and alcohol and physical growth patterns to age 8 years

Abstract

Two hundred and two primarily African American/Caribbean children (classified by maternal report and infant meconium as 38 heavier, 74 lighter and 89 not cocaine-exposed) were measured repeatedly from birth to age 8 years to assess whether there is an independent effect of pre-natal cocaine exposure on physical growth patterns. Children with fetal alcohol syndrome identifiable at birth were excluded. At birth, cocaine and alcohol exposures were significantly and independently associated with lower weight, length and head circumference in cross-sectional multiple regression analyses. The relationship over time of pre-natal exposures to weight, height, and head circumference was then examined by multiple linear regression using mixed linear models including covariates: child's gestational age, gender, ethnicity, age at assessment, current caregiver, birth mother's use of alcohol, marijuana and tobacco during the pregnancy and pre-pregnancy weight (for child's weight) and height (for child's height and head circumference). The cocaine effects did not persist beyond infancy in piecewise linear mixed models, but a significant and independent negative effect of pre-natal alcohol exposure persisted for weight, height, and head circumference. Catch-up growth in cocaine-exposed infants occurred primarily by 6 months of age for all growth parameters, with some small fluctuations in growth rates in the preschool age range but no detectable differences between heavier versus unexposed nor lighter versus unexposed thereafter.

Fetal Alcohol Growth Restriction and Cognitive Impairment

“…In other fetal growth restriction models, such as prenatal nicotine and amphetamine exposure, most children exhibit catch-up growth during the first year of life. 10,11 By contrast, our data show that a large proportion of children with heavy PAE exhibit growth restriction in utero that persists postnatally. Moreover, these data are the first to demonstrate that a child's growth trajectory pattern predicts severity of fetal alcohol-related neurocognitive impairment: the strongest effects were seen in children with both fetal and long-term postnatal growth restriction, more moderate effects in those with fetal growth restriction and postnatal catch-up growth, and the weakest effects in those without any growth restriction.…”

Effects of prenatal cocaine exposure on adolescent development

“…Some other studies have also reported that PCE has a detrimental effect on childhood growth (Covington et al, 2002;Minnes et al, 2006;Rivkin et al, 2008;Shankaran et al, 2011). However, others have reported that it has no effect at younger ages Bada et al, 2012;Frank et al, 2002;Lumeng et al, 2007;, and two studies reported that PCE was associated with increased body mass index and obesity in some subgroups of children Shankaran et al, 2010). To our knowledge, there have been no reports on the effects of PCE on adolescent growth.…”

Daily ethanol exposure during late ovine pregnancy: physiological effects in the mother and fetus in the apparent absence of overt fetal cerebral dysmorphology

“…High levels of EtOH exposure in human gestation have been associated with fetal growth restriction and delayed weight gain in childhood (16,24). Similarly, in pregnant sheep exposed to EtOH both prior to and throughout gestation, nearterm fetuses were lighter, shorter, and had decreased brain weight compared with controls (31).…”