Temperament and behavior of infants prenatally exposed to drugs: Clinical implications for the mother-infant dyad

Abstract

In trying to prevent developmental delays, we are continually searching for specific events or factors that are responsible for less than optimal development. Recept attention has focused on the effects of cocaine exposure in utero, with the most common effects appearing to be subtle neurobehavioral differences. The purpose of this study was to determine if, at the age of 6 months, infants exposed to cocaine exhibit significant differences in behavior and cognitive abilities. Results of this study revealed differences between exposed and nonexposed infants in both temperament and behavioral characteristics. Temperamentally, children prenatally exposed to cocaine were reported to be less cooperative, more difficult to manage, and more arrhythmic. The drug‐exposed group was also rated lower on behavioral characteristics of responsiveness, communication, and participation. The two groups were similar in terms of cognitive development. The impact of these behavioral effects on the mother‐infant relationship is discussed in terms of clinical and research implications of this study.

The effects of prenatal cocaine use on infant development

“…The descriptive analyses showed that the infants who were exposed throughout pregnancy were the most affected; those exposed during the first trimester only were also affected. Although there have been only a few published reports investigating the effects of cocaine exposure on infant temperament, our findings are consistent with those that reported an increase in fussiness and difficultness as a result of prenatal cocaine use [32,58]. The effects of cocaine use on infant temperament may result from the changes in autonomic stability, state regulation, and brain maturation that were found at birth.…”

“…There have been consistent reports of no detrimental effects of PCE on global cognitive development during infancy, as measured by the Mental Development Index (MDI) of the Bayley Scales of Infant Development (BSID [9] and BSID-II [10]) [4,12,13,20,21,32,36,41,43,48,[58][59][60]65]. Only a few studies have reported detrimental effects on MDI scores.…”

“…Mayes et al [58] reported that 3-month-old infants who were exposed to cocaine prenatally were more fussy and irritable during an information processing task than were non-exposed infants. Edmondson and Smith [32] found that 6-month-old infants who were prenatally exposed to cocaine were reported by their mothers to be more difficult (defined as uncooperative and arrhythmic) than non-exposed infants. However, in that study, there was no statistical control for other factors that differed between the exposed and non-exposed groups.…”

Reactivity and regulation of motor responses in cocaine-exposed infants

“…Some studies have reported the effects of prenatal cocaine exposure on infants’ activity level. However, the findings are largely inconsistent, with some suggesting increases in movement (Mayes et al, 1995, 1996; Struthers & Hansen, 1992) while others suggest a decrease in movement (Alessandri, et al, 1993; Edmondson & Smith, 1994; Martin, et al, 1996). …”

“…With the exception of Struthers and Hansen (1992), no studies of CE infants have explicitly examined reactivity and regulation specifically within the motor response system. A number of studies have looked at the activity level (i.e., amount of activity in general) CE infants exhibit (Alessandri et al, 1993; Edmondson & Smith, 1994; Martin et al, 1996; Mayes et al, 1995, 1996; Struthers & Hansen, 1992). However, reactivity of the motor system in response to specific stimuli has not been investigated to date in CE infants.…”