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Updated: Aug 19, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Predictors of motor development in children prenatally exposed to cocaine
Cynthia Miller-Loncar1, Barry M Lester, Ronald Seifer
1Brown Medical School, Women and Infants Hospital, Providence, RI 02903, United States. Cynthia_Loncar@brown.edu
Insights
Infants exposed to cocaine in utero showed initial motor skill delays but improved over time. Tobacco use negatively impacted motor performance, while heavy cocaine use correlated with poorer skills but not developmental trajectory.
Area of Science:
- Neurodevelopmental Pediatrics
- Prenatal Substance Exposure Research
Background:
- Prenatal exposure to substances like cocaine can impact infant development.
- Understanding the long-term effects of in utero drug exposure on motor skills is crucial.
Purpose of the Study:
- To investigate motor development patterns in infants with in utero cocaine exposure.
- To determine the relationship between prenatal drug exposure levels and motor development outcomes.
Main Methods:
- Longitudinal study tracking motor development from 1 to 18 months.
- Utilized standardized assessments: NNNS, PFMAI, BSID-II, PDMS.
- Employed hierarchical linear modeling (HLM) to analyze developmental trajectories.
Main Results:
- Cocaine-exposed infants demonstrated lower initial motor skills at 1 month but showed significant improvement over time.
- Higher and lower levels of tobacco use were associated with poorer motor performance.
- Heavy cocaine use correlated with poorer motor performance compared to no use, but did not affect the rate of change.
Conclusions:
- While cocaine exposure impacts early motor skills, infants show catch-up development.
- Tobacco use presents a significant risk factor for impaired motor development in infants.
- The level of cocaine exposure may not influence the trajectory of motor skill acquisition after initial deficits.
Abstract:
The current study examined the pattern of motor development across the first 18 months of life in infants with in utero exposure to cocaine to determine how prenatal drug effects and level of exposure relates to motor development. Motor development was examined at 1, 4, 12, and 18 months of age (corrected for prematurity). Infants were divided into cocaine exposed (n=392) and comparison (n=776) groups. Exposure status was determined by meconium assay and maternal self-report with alcohol, marijuana, tobacco, and opiates present in both groups. Motor skills were assessed at 1 month using the NICU Network Neurobehavioral Scale (NNNS), at 4 months using the posture and fine motor assessment of infants (PFMAI), at 12 months using the Bayley Scales of Infant Development-Second Edition (BSID-II), and at 18 months using the Peabody Developmental Motor Scales (PDMS). Examiners masked to exposure status performed all assessments. Motor scores were converted to standard (z) scores, and hierarchical linear modeling (HLM) was used to examine the change in motor skills from 1 to 18 months of age. Infants with exposure to cocaine showed low motor skills at their initial status of 1 month but displayed significant increases over time. Both higher and lower levels of tobacco use related to poorer motor performance on average. Heavy cocaine use related to poorer motor performance as compared to no use, but there were no effects of level of cocaine use on change in motor skills.
