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Updated: Jul 27, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Cognitive and motor outcomes of cocaine-exposed infants
Lynn T Singer1, Robert Arendt, Sonia Minnes
1Department of Pediatrics, Case Western Reserve University, Triangle Bldg, 11400 Euclid Ave, Suite 250-A, Cleveland, OH 44106, USA. lxs5@po.cwru.edu
Context:
Maternal use of cocaine during pregnancy remains a significant public health problem, particularly in urban areas of the United States and among women of low socioeconomic status. Few longitudinal studies have examined cocaine-exposed infants, however, and findings are contradictory because of methodologic limitations.
Objective:
To assess the effects of prenatal cocaine exposure on child developmental outcomes.
Design:
Longitudinal, prospective, masked, comparison birth cohort study with recruitment in 1994-1996.
Setting:
Obstetric unit of a large US urban teaching hospital.
Participants:
Four hundred fifteen consecutively enrolled infants (218 cocaine-exposed and 197 unexposed) identified from a high-risk, low-socioeconomic status, primarily black (80%) population screened through clinical interview and urine and meconium samples for drug use. The retention rate was 94% at 2 years of age.
Main Outcome Measures:
The Bayley Mental and Motor Scales of Infant Development, assessed at 6.5, 12, and 24 months of corrected age.
Results:
Controlled for confounding variables, cocaine exposure had significant effects on cognitive development, accounting for a 6-point deficit in Bayley Mental and Motor Scales of Infant Development scores at 2 years, with cocaine-exposed children twice as likely to have significant delay (mental development index <80) (odds ratio, 1.98; 95% confidence interval, 1.21-3.24; P =.006). For motor outcomes, there were no significant cocaine effects.
Conclusions:
Cocaine-exposed children had significant cognitive deficits and a doubling of the rate of developmental delay during the first 2 years of life. Because 2-year outcomes are predictive of later cognitive outcomes, it is possible that these children will continue to have learning difficulties at school age.
