The Developmental Implications of Prenatal and/or Postnatal Crack Cocaine Exposure in Preschool Children

Bender, Suzanne L.; Word, Carl O.; DiClemente, Ralph J.; Crittenden, Mary R.; Persaud, Nalini A.; Ponton, Lynn E.

doi:10.1097/00004703-199512000-00005

Cited by 51 publications

(30 citation statements)

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“…A small study found signs of visual stress and poorer visual following in cocaine-exposed newborns (Napiorkowski et al, 1996), although obstetric drugs may have confounded these findings. The present study's findings are also consistent with reports of the relationship of cocaine exposure to attentional difficulties in preterm (Singer et al, 1994) and term (Arendt et al, 1998) infants at older ages, and to reports of relative impairment in visual-motor abilities in small samples of cocaine-exposed children at preschool age (Bender et al, 1995).…”

Section: Discussionsupporting

confidence: 90%

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

Singer

Arendt

Fagan

et al. 1999

Infant Behavior and Development

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This study investigated early neonatal visual preferences in 267 poly drug exposed neonates (131 cocaine-exposed and 136 non-cocaine exposed) whose drug exposure was documented through interviews and urine and meconium drug screens. Infants were given four visual recognition memory tasks comparing looking time to familiarized stimuli of lattices and rectangular shapes to novel stimuli of a schematic face and curved hourglass and bull's eye forms. Cocaine-exposed infants performed more poorly, after consideration of confounding factors, with a relationship of severity of cocaine exposure to lower novelty score found for both self-report and biologic measures of exposure, Findings support theories which link prenatal cocaine exposure to deficits in information processing entailing attentional and arousal organizational systems. Neonatal visual discrimination and attention tasks should be further explored as potentially sensitive behavioral indicators of teratologic effects. Keywordscocaine; neonatal visual attention; information processing; marijuana; alcohol poly drug exposure; visual recognition memory Over the past decade, prenatal cocaine exposure has emerged as a significant public health problem, affecting 5-15% of infants in urban areas of the United States. There is concern and controversy over cocaine's teratogenic potential since cocaine easily crosses the placental barrier during gestation (Woods, Plessinger, & Clark, 1987). This transmission of cocaine may directly and indirectly affect the fetus. Cocaine's stimulant effects on several neurotransmitter systems in adults have been noted (Wise, 1984), as cocaine prevents the reuptake of catecholamine presynaptically and has been found to affect primarily the cardiovascular, respiratory, and central nervous systems.There are a number of different mechanisms by which prenatal cocaine exposure could affect fetal development (Volpe, 1992). Alterations in catecholamine levels during gestation may affect the maturation of fetal neurotransmitter systems (Tennyson, Gershon, Budinkas, Copyright © 1999 Elsevier Science Inc.• Lynn T. Singer, The Triangle Building, 11400 Euclid Avenue, Suite 250-A, Cleveland, Ohio 44106; Phone: (216) Fax: (216) & Rothman, 1983;Wang & Schnoll, 1986). Animal studies have found that prenatal cocaine exposure is associated with increased catecholaminergic fiber densities in selected brain areas such as the posterior parietal cortex (Akbari & Azmitra, 1992;Posner & Peterson, 1988). Cocaine exposure may affect fetal brain development through its release and metabolism of monoamines, which are important in the definition of fetal brain structure and neuronal formation . In addition, the reduction of blood flow prenatally to cocaine-exposed fetuses may affect later infant information processing or problem solving .The early behavioral development of cocaine-exposed infants has been studied using measures of sensory-motor processing such as the Brazelton Neonatal Behavioral Assessment Scale (NBAS), (Brazelton, 1984) neonatall...

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Section: Discussionsupporting

confidence: 90%

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

Singer

Arendt

Fagan

et al. 1999

Infant Behavior and Development

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“…Others have noted results consistent with the findings of the present study, but the sample sizes were appreciably smaller and none reported results past the preschool period. These studies have reported cocaine-associated deficits on various standardized tests of total language (Johnson et al, 1997;Singer et al, 2001a), expressive and receptive language (Chapman, 2000;Koren et al, 1998;Nulman et al, 1994Nulman et al, , 2001van Baar and de Graaff, 1994), expressive but not receptive language (Singer et al, 2001a), and receptive but not expressive language (Bender et al, 1995). Additional supportive evidence for cocaine-associated language deficits is provided by studies of small groups of children in whom spontaneous language samples have been coded to assess semantic and syntactical processing elements of language.…”

Section: Discussionmentioning

confidence: 99%

Severity of Prenatal Cocaine Exposure and Child Language Functioning Through Age Seven Years: A Longitudinal Latent Growth Curve Analysis

Bandstra

Vogel

Morrow

et al. 2004

Substance Use & Misuse

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The current study estimates the longitudinal effects of severity of prenatal cocaine exposure on language functioning in an urban sample of full-term African-American children (200 cocaineexposed, 176 noncocaine-exposed) through age 7 years. The Miami Prenatal Cocaine Study sample was enrolled prospectively at birth, with documentation of prenatal drug exposure status through maternal interview and toxicology assays of maternal and infant urine and infant meconium. Language functioning was measured at ages 3 and 5 years using the Clinical Evaluation of Language Fundamentals-Preschool (CELF-P) and at age 7 years using the Core Language Domain of the NEPSY: A Developmental Neuropsychological Assessment. Longitudinal latent growth curve analyses were used to examine two components of language functioning, a more stable aptitude for language performance and a time-varying trajectory of language development, across the three time points and their relationship to varying levels of prenatal cocaine exposure. Severity of prenatal cocaine exposure was characterized using a latent construct combining maternal self-report of cocaine use during pregnancy by trimesters and maternal and infant bioassays, allowing all available information to be taken into account. The association between severity of exposure and language functioning was examined within a model including factors for fetal growth, gestational age, and IQ as intercorrelated response variables and child's age, gender, and prenatal alcohol, tobacco, and marijuana exposure as covariates. Results indicated that greater severity of prenatal cocaine exposure was associated with greater deficits within the more stable aptitude for language performance (D = −0.071, 95% CI = −0.133, −0.009; p = 0.026). There was no relationship between severity of prenatal cocaine exposure and the time-varying trajectory of language development. The observed cocaineassociated deficit was independent of multiple alternative suspected sources of variation in language performance, including other potential responses to prenatal cocaine exposure, such as child's intellectual functioning, and other birth and postnatal influences, including language stimulation in the home environment.

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“…43,44 For example, in a separate ongoing study involving a different but demographically similar group of mothers from the same inner city population, drug use data were collected at birth and at 6 months. Of those who were using cocaine at the time of delivery, 80% returned for the 6-month follow-up.…”

Section: Discussionmentioning

confidence: 99%

Motor Development of Cocaine-exposed Children at Age Two Years

et al. 1999

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Objective-This article was designed to investigate effects of prenatal cocaine exposure on motor development of young children from a predominately underprivileged, urban population.Methodology-A total of 260 infants and young children were initially recruited from either the newborn nursery or the at-risk pediatric clinic of an urban teaching hospital. Prenatal history and birth outcomes were collected from medical records. Demographic characteristics and additional drug histories were obtained from the mothers. The 199 subjects (98 cocaine-exposed and 101 unexposed) who returned at age 2 years were assessed by examiners blinded to drug exposure status using the Peabody Developmental Motor Scales.Results-Compared with control subjects, the cocaine-exposed group performed significantly less well on both the fine and the gross motor development indices. Mean scores for both groups were within the average range on the gross motor index, but greater than 1 standard deviation below average on the fine motor index. Differences were significant on the balance and the receipt and propulsion subscales of the gross motor scale, and on the hand use and the eye-hand coordination subscales of the fine motor scale. Cocaine status independently predicted poorer hand use and eye-hand coordination scores. There also was an effect of alcohol exposure on the receipt and propulsion subscale.Conclusions-Findings indicate that deficiencies in motor development remain detectable at 2 years of age in children exposed to drugs prenatally. Although other environmental variables may influence motor development, children exposed to cocaine and to alcohol in utero may encounter developmental challenges that impede later achievement.Although the recent epidemic of cocaine use may have subsided, 1,2 concerns about the development of many children exposed to cocaine in utero remain relevant. There are several possible mechanisms by which cocaine may damage the developing nervous system of the human fetus, 3 suggesting that neural functions associated with movement, such as those regulated by the hypothalamic and extrapyramidal systems, should be examined closely. Specific findings demonstrating a strong and explicit effect of fetal cocaine Copyright © 1999 exposure on infant development, however, have been difficult to confirm, in part because of numerous confounding factors. 4 In particular, many studies had small sample sizes and/or lacked control for the polydrug exposure that is commonly associated with cocaine exposure. Additionally, previous research frequently failed to consider other factors, such as amount of prenatal care, maternal education, and prematurity, that also have been shown to affect developmental outcome. 5,6 Numerous studies have focused on the neurobehavioral sequelae of prenatal cocaine exposure on newborns or young infants, many of which reported significant negative effects of cocaine exposure. Reviews of this literature, however, note several inconsistencies in the nature and extent of the deficits. 7,8 A...

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The Developmental Implications of Prenatal and/or Postnatal Crack Cocaine Exposure in Preschool Children

Cited by 51 publications

References 0 publications

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

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

Severity of Prenatal Cocaine Exposure and Child Language Functioning Through Age Seven Years: A Longitudinal Latent Growth Curve Analysis

Motor Development of Cocaine-exposed Children at Age Two Years

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