Prenatal cocaine exposure and age of sexual initiation: Direct and indirect effects

Abstract

Background Prenatal cocaine exposure (PCE) has been linked to child behavior problems and risky behavior during adolescence such as early substance use. Behavior problems and early substance use are associated with earlier initiation of sexual behavior. The goal of this study was to examine the direct and indirect effects of PCE on sexual initiation in a longitudinal birth cohort, about half of whom were exposed to cocaine in utero. Methods Women were interviewed twice prenatally, at delivery, and 1, 3, 7, 10, 15, and 21 years postpartum. Offspring (52% female, 54% African American) were assessed at delivery and at each follow-up phase with age-appropriate assessments. At age 21, 225 offspring reported on their substance use and sexual behavior. Results First trimester cocaine exposure was a significant predictor of earlier age of first intercourse in a survival analysis, after controlling for race, sociodemographic characteristics, caregiver pre- and postnatal substance use, parental supervision, and child’s pubertal timing. However, the association between PCE and age of first sexual intercourse was mediated by adolescent marijuana and alcohol use prior to age 15. Conclusions Most of the effect of PCE on age of sexual initiation occurred between the ages of 13 to 18, when rates of initiation were approximately 10% higher among exposed offspring. This effect was mediated by early adolescent substance use. These results have implications for identification of the exposed offspring at greatest risk of HIV risk behaviors and early, unplanned pregnancy.

Effects of prenatal cocaine exposure on early sexual behavior: Gender difference in externalizing behavior as a mediator

“…That is, although PCE effects on early sexual initiation was observed for both boys and girls, its underlying mechanism was gender-dependent, indicating childhood externalizing behavior as a pathway only for girls. Our study is in line with two previous studies indicating a greater risk of early sexual initiation among PCE adolescents (De Genna et al, 2014; Lambert et al, 2013), despite methodological differences in operationalization of early sexual initiation and analytical approaches. A stronger relationship between externalizing behavior and early sexual initiation for girls than for boys was observed in our high risk sample, although large population-based studies identified childhood externalizing behavior as a risk factor regardless of gender (McLeod and Knight, 2010; Skinner et al, 2015).…”

“…To date, three studies from two prospective cohorts have investigated the effects of PCE on adolescent sexual behavior (Conradt et al, 2014; De Genna et al, 2014; Lambert et al, 2013). First trimester PCE was a significant predictor of early sexual intercourse, with most PCE effects occurring between the ages of 13–18 when rates of initiation of sexual intercourse were approximately 10% higher among adolescents with PCE (De Genna et al, 2014).…”

“…First trimester PCE was a significant predictor of early sexual intercourse, with most PCE effects occurring between the ages of 13–18 when rates of initiation of sexual intercourse were approximately 10% higher among adolescents with PCE (De Genna et al, 2014). They also found that the effect of PCE was fully mediated by marijuana and alcohol use prior to age 15, but not by caregiver-reported externalizing behavior at age 7.…”

Trends in Sexual Behaviour in Czech Schoolchildren between 2002-2014.

“…One of the strongest correlates of early sex is substance use (2). Correlation between early sexual onset and more frequent use of addictive substances were well documented in the systematic review of Zimmer-Gembeck and Helfand, which compared 35 studies on this topic (3).…”

Pathways to adolescent sexual risk behaviors: Effects of prenatal cocaine exposure

“…Prenatal cocaine exposure (PCE) may increase the vulnerability for adolescent sexual risk behavior (De Genna et al, 2014; Lambert et al, 2013; Min et al, 2015). Approximately 214,000 infants are exposed in utero to illicit drugs, including cocaine, each year in the United States (Substance Abuse and Mental Health Services Administration (SAMHSA), 2014); however, the effects of PCE on adolescent sexual behavior have not been well-established, with only three published studies from three prospective birth cohorts to date (De Genna et al, 2014; Lambert et al, 2013; Min et al, 2015).…”