Prenatal cocaine exposure and child outcomes: a conference report based on a prospective study from Cleveland

Abstract

Objective The study aims to describe developmental outcomes from a longitudinal prospective cohort (Cleveland study) of prenatally cocaine-exposed (CE) infants. Methods Two hundred eighteen CE and 197 nonexposed infants were enrolled at birth and followed through mid-adolescence. Birth CE status was determined by interview and biologic measures. Multiple demographic, drug, and environmental correlates were controlled. Standardized, normative, reliable measures of fetal growth, intelligence quotient (IQ), behavior, executive function, and language were given at each age and risk for substance misuse assessed in adolescence. A subset of children received volumetric magnetic resonance imaging (MRI) at 7 years and functional MRI at 14 years. The effect of CE was determined through multiple regression analyses controlling for confounders. Results Cocaine exposed had significant negative effects on fetal growth, attention, executive function, language, and behavior, while overall IQ was not affected. CE had significant negative effects on perceptual reasoning IQ and visual–motor skills and predicted lower volume of corpus callosum and decreased gray matter in the occipital and parietal lobes. CE children had higher risk for substance misuse. Confounding risk factors had additive effects on developmental outcomes. Conclusions Prenatal exposure to cocaine was related to poorer perceptual organization IQ, visual–spatial information processing, attention, language, executive function, and behavior regulation through early adolescence.

The association of prenatal cocaine exposure, externalizing behavior and adolescent substance use

“…Elevated blood lead levels, which often co-occur within low socioeconomic status households and, therefore, at high rates in our sample (Min et al, 2009), are also associated with increased risk of behavioral problems in childhood through early adulthood in the general population (Wasserman et al, 1998; Burns et al, 1999; Lane et al, 2008; Wright et al, 2008), and were found to be related to alcohol use in adolescents with PCE (Minnes et al, 2014a,b). Other caregiver characteristics known to independently influence behavioral outcomes include caregiver psychological distress, receptive vocabulary skills, non-verbal reasoning ability and quality of the home environment (Bennett et al, 2008; Singer et al, 2008; Singer et al, 2015). Generally, poor environmental and socioeconomic conditions are often prevalent among parents with substance use disorders and are important factors to consider in evaluating the relationship between PCE and teen substance use.…”

Prenatal cocaine exposure and its impact on cognitive functions of offspring: a pathophysiological insight

“…These authors observed that children prenatally exposed to COC are more likely to manifest cognitive deficits in subareas of IQ (visuospatial skills, general knowledge, and arithmetic skills) but that they did not exhibit a lower global IQ (Singer et al, 2004). In a recent study, the same researchers observed a negative impact of prenatal COC exposure on perceptual reasoning IQ; however, the children's global IQ remained unaffected (Singer et al, 2015). Future studies should accordingly specifically target various IQ subdomains to draw firm conclusions.…”

A comparison of common practices for identifying substance use during pregnancy in obstetric clinics

“…Cocaine use during pregnancy is associated with placental abruption, premature rupture of membranes, preterm labor, preterm delivery, maternal seizures, maternal hypertension, and uterine contractions . Poor behavioral adjustment and executive function through adolescence may result from perinatal cocaine exposure . Similarly, infants born to women using opiates are at risk for neonatal abstinence syndrome, which is characterized by hyperactivity of the central and autonomic nervous systems .…”