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

Abstract

The use of cocaine and other drugs during pregnancy may have serious public health consequences. The objective of this study was to determine if the use of cocaine prenatally identifies women for ongoing risk of psychological symptoms. Four hundred and two women (207 cocaine using [C], 195 non-cocaine using [NC]) were assessed for rates of clinically elevated psychological symptoms shortly after childbirth, 6.5 months and 1, 2, 4 and 6 years after using the Brief Symptom Inventory (BSI). Generalized estimating equation modeling (GEE) was used to compare psychological symptom severity, controlling for confounding factors including early childhood trauma. Results indicated that women identified as having used cocaine during pregnancy had clinically elevated psychological distress (OR=1. who use cocaine during pregnancy should be recognized as at very high risk of ongoing clinically elevated psychological symptoms and should receive early and regular assessments and intervention for mental health and substance use problems.

Association of prenatal cocaine exposure, childhood maltreatment, and responses to stress in adolescence

“…Children with PCE tend to grow up in suboptimal parenting and caregiving environments, characterized by lower levels of maternal education (Singer et al, 2002; Singer et al, 2004), ongoing caregiver substance use and psychological distress (Singer et al, 1997; Minnes et al, 2008; Molnar et al, 2014), and lack of social support (Min et al, 2013a; Nordstrom et al, 2005), conducive to potential child maltreatment. The deleterious effects of childhood maltreatment (CM) have been widely recognized (Teicher and Samson, 2016; De Bellis, 2001), with both retrospective and prospective studies reporting associations between CM and poorer psychological (Buckingham and Dianiolos, 2013; Keyes et al, 2011; Min et al, 2007) and physical functioning in adulthood (Felitti et al, 1998; Min et al, 2013b).…”

Percepção de mulheres usuárias de crack sobre a influência da droga na gestação e parto [Women crack users’ perceptions of the drug’s influence on pregnancy and childbirth]

“…Estudos reforçam que mulheres que usam crack são vulneráveis ao HIV e outras infecções sexualmente transmissíveis, devido ao comportamento sexual de risco, como troca de sexo por substâncias psicoativas, carência do uso de preservativos com múltiplos parceiros, história de vitimização física e sexual, problemas com a justiça criminal, falta de habitação estável e desemprego [16][17][18] . Em relação à percepção acerca do parto, estudo mostra que a conduta mais apropriada nesses casos é o parto vaginal com analgesia.…”

Cocaine use during pregnancy and health outcome after 10 years

“…Many of cocaine’s effects on psychological functioning occur following withdrawal between administrations and include irritability, depression, insomnia and agitation. Psychological symptoms after chronic use include somatic complaints (Johanson et al, 1999; Watson et al, 1992), eating disorders (Ross-Durow and Boyd, 2000), anxiety, depression (Beckwith et al, 1999; Falck et al, 2002) and overall psychological distress post-partum (Singer et al, 1997, 1995) and up to six years after (Minnes et al, 2008b). …”

“…These drugs are consumed in efforts to control immediate or extended withdrawal symptoms such as insomnia, anxiety, depression and/or inattentiveness (Chaves et al, 2011; Ribeiro et al, 2010). Subsequently, the use of alcohol, marijuana and tobacco occurs at greater rates and higher amounts among women who use cocaine prenatally both during pregnancy and after (Minnes et al, 2008b). Such habitual use of these substances is also independently associated with poorer physical health outcomes (Hall and Degenhardt, 2009; Nolen-Hoeksema, 2004; Strandberg et al, 2008) and negative mental health outcomes for tobacco (Parrott, 2006).…”