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Updated: Jun 13, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Children of addicted women
Barry M Lester1, Linda L Lagasse
1Brown Center for the Study of Children at Risk, The Warren Alpert Medical School of Brown University, Women and Infants Hospital of Rhode Island, Providence, RI 02905, USA. blester@wihri.org
Insights
Prenatal drug exposure to cocaine, methamphetamine, and opiates can impact child development. Long-term studies show effects on behavior, attention, language, and cognition, with neuroimaging offering new insights.
Area of Science:
- Developmental Psychology
- Neuroscience
- Pediatrics
Background:
- Prenatal drug exposure presents significant challenges to child development.
- Existing research primarily focuses on cocaine, with emerging data on methamphetamine and opiates.
Purpose of the Study:
- To review follow-up studies on children exposed prenatally to drugs (cocaine, methamphetamine, opiates).
- To examine the long-term effects on behavior and development from preschool through adolescence.
Main Methods:
- Systematic review of existing literature on prenatal drug exposure.
- Analysis of studies controlling for confounding factors.
- Inclusion of research utilizing neuroimaging techniques.
Main Results:
- Prenatal cocaine exposure is linked to unique effects in children aged 4-13, impacting behavior, attention, language, and cognition.
- Methamphetamine exposure shows similar developmental effects to cocaine.
- Opiate exposure literature is less extensive, with a notable lack of recent studies on prescription medication impacts.
Conclusions:
- Prenatal drug exposure has lasting effects on child development.
- Neuroimaging offers promising avenues for understanding brain-behavior relationships.
- The 'fetal origins' model provides a framework for understanding drug exposure impacts via fetal programming and the neuroendocrine system.
Abstract:
The purpose of this article was to review follow up studies of children with prenatal drug exposure from preschool through adolescence. Specifically, the authors focus on the effects of prenatal exposure to cocaine, methamphetamine, and opiates on behavior and development. The largest number of studies have examined cocaine-exposed children. The authors identified 42 studies that suggest that there are unique effects of prenatal cocaine exposure on 4- to 13-year-old children, particularly in the areas of behavior problems, attention, language, and cognition. In addition, studies make reasonable attempts to control for possible confounding factors. Systematic research on the long-term effects of prenatal methamphetamine exposure is just beginning but seems to be showing similar effects to that of cocaine. The literature on the on the long-term effects of children with prenatal opiate exposure is more substantial than the methamphetamine literature but it is still relatively sparse and surprising in that there is little recent work. Thus, there are no studies on the current concerns with opiates used for prescription mediation. There is a growing literature using neuroimaging techniques to study the effects of prenatal drug exposure that holds promise for understanding brain/behavior relationships. In addition to pharmacological and teratogenic effects, drugs can also be viewed from a prenatal stressor model. The author discuss this "fetal origins" approach that involves fetal programming and the neuroendocrine system and the potential implications for adolescent brain and behavioral development.
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