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Prenatal cocaine exposure: Effects on mother- and teacher-rated behavior problems and growth in school-age children
Gale A Richardson1, Lidush Goldschmidt, Sharon Leech
1University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. gar@pitt.edu
Insights
Prenatal cocaine exposure (PCE) in early pregnancy affected child growth, while later exposure impacted behavior. Continuous exposure led to more behavioral issues in school-aged children.
Area of Science:
- Developmental Psychology
- Neuroscience
- Pediatrics
Background:
- Prenatal cocaine exposure (PCE) is a significant concern impacting child development.
- Longitudinal studies are crucial for understanding the long-term effects of PCE.
- Controlling for confounding factors is essential in assessing PCE's true impact.
Purpose of the Study:
- To examine the effects of prenatal cocaine exposure (PCE) on school-age physical, cognitive, and behavioral development.
- To identify specific developmental outcomes associated with cocaine use during different pregnancy trimesters.
- To compare outcomes between children with varying levels of prenatal cocaine exposure.
Main Methods:
- Longitudinal study design tracking children exposed to cocaine prenatally.
- Assessment of physical growth (weight, height), cognitive function, and behavior at school age (average 7.2 years).
- Utilized validated instruments including Child Behavior Checklist, Teacher Report Form, Routh Activity, and SNAP scales.
Main Results:
- First trimester cocaine exposure was linked to reduced weight and height at age 7.
- No significant associations were found between PCE and cognitive/neuropsychological measures.
- Third trimester cocaine use correlated with increased externalizing and total behavior problems.
- Continuous prenatal cocaine exposure resulted in more mother- and teacher-rated behavioral issues.
Conclusions:
- Prenatal cocaine exposure, particularly in later pregnancy, significantly impacts behavioral development in school-aged children.
- These behavioral changes may stem from altered neurotransmitter systems and could predict future adolescent problems.
- While early exposure affected physical growth, later and continuous exposure poses greater risks for behavioral disturbances.
Abstract:
In this longitudinal study of prenatal cocaine exposure (PCE), school-age physical and cognitive development and behavioral characteristics were examined, while controlling for other factors that affect child development. At this follow-up phase, children were on average 7.2 years old, and their caregivers were 33.7 years old, had 12.5 years of education, and 48% were African American. During the first trimester, 20% of the women were frequent cocaine users (≥1 line/day). First trimester cocaine exposure predicted decreased weight and height at 7 years. There was no significant relationship between PCE and the cognitive and neuropsychological measures. Third trimester cocaine use predicted more total and externalizing behavior problems on the Child Behavior Checklist (Achenbach, 1991 [3]) and the Teacher Report Form (Achenbach, 1991 [4]), and increased activity, inattention, and impulsivity on the Routh Activity (Routh et al., 1974 [67]) and SNAP scales (Pelham and Bender, 1982 [55]). Children who were exposed to cocaine throughout pregnancy had more mother- and teacher-rated behavior problems compared to children of women who stopped using early in pregnancy or who never used cocaine prenatally. These detrimental effects of PCE on behavior are consistent with other reports in the literature and with the hypothesis that PCE affects development through changes in neurotransmitter systems. These school-age behaviors may be precursors of later adolescent behavior problems.
