Relationship of prenatal cocaine exposure and maternal postpartum psychological distress to child developmental outcome

Abstract

Maternal cocaine use during pregnancy can affect the infant directly through toxic effects or indirectly through cocaine's influence on maternal psychological status. We followed 160 cocaine exposed and 56 nonexposed infants and their mothers identified at birth through interview and/or urine screen. Although cocaine exposure defined the groups, infant exposure to alcohol, marijuana, and tobacco was allowed to vary. Infants were 99% African American and poor. All mothers completed the Brief Symptom Inventory (BSI) and infants were given the Bayley Scales of Mental (MDI) and Motor (PDI) Development at a mean corrected age of 17 ± 8 months. Both MDIs (94 ± 17 vs. 103 ± 16) and PDIs (101 ± 16 vs. 108 ± 12) were lower for cocaine exposed infants. Psychological distress was greater in cocaine using mothers. Hierarchical multiple regression was used to assess the relative effects of gestational age, maternal psychological distress, and cocaine and polydrug exposure on infant outcomes. Both psychological distress and cocaine and alcohol exposure predicted lower MDIs after controlling for prematurity. Neither psychological distress nor alcohol exposure predicted motor outcome, while cocaine had a significant effect. Tobacco and marijuana exposure were unrelated to outcome. These findings provide further support for direct effects of cocaine and alcohol on infant development, as well as highlight the need for studies to document maternal psychological factors, which may increase child risk for poorer outcomes.

Impact of Prenatal Chlorpyrifos Exposure on Neurodevelopment in the First 3 Years of Life Among Inner-City Children

“…66,67 Children who are exposed prenatally to well-studied toxicants (such as lead, ETS, or cocaine) exhibit the same kind of decline in cognitive scores during the early preschool years as seen among low-income children. [68][69][70][71] This report is the first to show that prenatal organophosphate exposure generates a similar pattern. It is not yet known whether children from low-income families have a more difficult time than less-deprived children in recovering from the effects of prenatal chlorpyrifos exposure or whether additional stimulation can compensate for some of the adverse effects of early toxic exposures on cognitive development in low-income populations.…”

The association of prenatal cocaine use and childhood trauma with psychological symptoms over 6 years

“…High rates of maternal psychopathology pose threats to infant well-being as well. Maternal psychological distress is associated with higher rates of child abuse and neglect (Berger 2005;Burke 2003), lower quality mother infant interaction (Minnes et al 2005;Singer et al 1996), lower cognitive and language outcomes (Singer et al 1997(Singer et al , 1999 and poor attachment and social behavior among infants (Hipwell et al 2000). Given the nature and severity of these symptoms, and the potential harm to mother and children, targeted interventions for mothers and infants should be started as soon as possible during the postpartum period.…”

“…Among the recognized consequences, maternal cocaine use has been related to increased rates of postpartum maternal psychological distress compared to similar, non-cocaine using women (Singer et al 1995(Singer et al , 1997. A history of early childhood trauma, which is prevalent among women who abuse drugs, has also been linked to higher rates of psychological symptoms (Jantzen et al 1998).…”

“…Negative effects of psychological symptoms on parenting include less sensitive maternal care giving behavior, experience of parenting stress and poor infant attachment (Eiden et al 2006;Espinosa et al 2001;Howard et al 1195;Minnes et al 2005;Sheinkopf et al 2006) and less optimal infant cognitive (Singer et al 1997) and language outcomes (Marques et al 2007). Despite the known negative effects of psychological distress on parenting among cocaine using women, very little is known about the natural history of mental health symptoms among cocaine using mothers (Jantzen et al 1998;Minnes et al 2000Minnes et al , 2008.…”

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

“…Findings have been inconsistent among studies. Some reports have found developmental deficits in cocaine-exposed infants compared to non-exposed infants (Arendt, Singer, Angelopoulos, Busdieker, & Mascia, 1998;Chasnoff, Griffith, Freier, & Murray, 1992;Coles, Platzman, Smith, James, & Falek, 1992;Eisen et al, 1991;Griffith, Azuma, & Chasnoff, 1994;Mayes, Bornstein, Chawarska, & Granger, 1995;Singer et al, 1997;Singer et al, 1994), while other reports have not found a difference based on exposure (Graham et al, 1992;Neuspiel, Hamel, Hochberg, Green, & Campbell, 1991;Richardson & Day, 1991;Woods, Eyler, Behnke, & Conlon, 1993;Hurt et al, 1995). In addition, cocaine's effects on arousal systems may differ from its effects on cognition .…”