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Updated: Aug 29, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Prenatal cocaine exposure and infant performance on the Brazelton Neonatal Behavioral Assessment Scale
Barbara J Myers1, Kathryn S Dawson, Gena C Britt
1Virginia Commonwealth University, Richmond, Virginia 23284-2018, USA. bmyers@vcu.edu
Insights
Infants exposed to drugs did not show significant differences in behavior compared to nonexposed infants. Motor skills improved, but state regulation declined in all infants over time.
Area of Science:
- Neonatal development
- Pediatric behavioral science
- Substance abuse research
Background:
- Maternal substance use during pregnancy can impact infant neurodevelopment.
- Understanding the long-term effects of prenatal drug exposure is crucial for early intervention.
- Previous research has yielded mixed results on the behavioral outcomes of drug-exposed infants.
Purpose of the Study:
- To investigate the behavioral differences in infants exposed to cocaine and poly-drugs compared to nonexposed infants.
- To assess the impact of maternal drug use treatment on infant neurobehavioral outcomes.
- To examine changes in infant behavior from early infancy to 4 weeks of age.
Main Methods:
- A cohort of 137 infants was studied, categorized into three groups: drug users in treatment, drug users not in treatment, and nonusers.
- Infants were assessed using the Neonatal Behavioral Assessment Scale (NBAS) at 2 days and 2-4 weeks postpartum.
- Regression analyses were performed to control for confounding variables and assess group differences.
Main Results:
- No significant differences were observed between drug-exposed and nonexposed infants on NBAS clusters or birth characteristics.
- A significant improvement in the motor cluster and a worsening in regulation of state were noted from time 1 to time 2 across all infants.
- No group-by-time interactions were found, indicating consistent developmental trajectories regardless of maternal drug exposure status.
Conclusions:
- Prenatal drug exposure, in this cohort, did not lead to detectable differences in neurobehavioral outcomes at 2 days or 2-4 weeks of age.
- Infant behavioral development, specifically motor skills and state regulation, followed similar trajectories in both exposed and nonexposed groups.
- The study's sufficient sample size and power indicate that the lack of group differences is likely a true finding, not due to insufficient statistical power.
Abstract:
Drug-exposed infants did not differ from nonexposed infants on Neonatal Behavioral Assessment Scale (NBAS) clusters or on birth characteristics. Infants (n = 137) born to three groups of low-income mothers--cocaine and poly-drug-using mothers in a drug user treatment group (n = 76) and in a treatment rejecter group (n = 18), and to a nonuser group (n = 43)--were examined at 2 days and 2-4 weeks. The motor cluster improved and regulation of state worsened from time 1 to 2. There were no interactions of group by time. Regression analyses were conducted to see whether group differences might either emerge or disappear after removing effects of competing variables, but they did not. Power analysis showed that sample size was sufficient to have detected group differences.
