Related Experiment Video
Updated: Jun 1, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Estimated effect of prenatal cocaine exposure on examiner-rated behavior at age 7 years
Veronica H Accornero1, James C Anthony, Connie E Morrow
1University of Miami Miller School of Medicine, Department of Pediatrics, Miami, FL 33101, United States. vaccornero@med.miami.edu
Insights
Prenatal cocaine exposure was linked to poorer behavioral regulation in 7-year-olds, as observed by blinded examiners. This contrasts with parent reports, suggesting trained observers offer valuable insights into developmental outcomes.
Area of Science:
- Developmental Psychology
- Neuroscience
- Public Health
Background:
- Prenatal cocaine exposure is a significant concern with debated links to child behavior difficulties.
- Previous research has yielded inconsistent findings regarding the impact of in utero cocaine exposure on child behavior.
Purpose of the Study:
- To estimate the relationship between prenatal cocaine exposure and child behavioral functioning at age 7 years.
- To investigate if caregiver drug use or psychological issues mediate the effects of prenatal cocaine exposure on child behavior.
Main Methods:
- Utilized data from 407 children (212 cocaine-exposed, 195 non-exposed) in the Miami Prenatal Cocaine Study.
- Employed blinded, trained psychometricians to rate child behavior during a neuropsychological assessment at age 7.
- Applied latent variable modeling to analyze the association between prenatal cocaine exposure and behavioral outcomes.
Main Results:
- Prenatal cocaine exposure was significantly associated with poorer Behavioral Regulation (ß=-0.25, p=0.04) but not Sociability.
- These findings controlled for child sex, age, and prenatal exposure to alcohol, tobacco, and marijuana.
- Caregiver postnatal drug use and psychological problems did not predict child behavior at age 7.
Conclusions:
- Examiner ratings indicated less optimal behavioral regulation in prenatally cocaine-exposed children compared to controls.
- This contrasts with previous parent-report findings, highlighting potential discrepancies in reporting methods.
- Trained observer assessments may provide valuable, objective insights into behavioral outcomes following prenatal exposure to toxicants.
Unlabelled:
Prenatal cocaine exposure has been linked to increased child behavior difficulties in some studies but not others.
Objective:
The primary aim was to estimate the relationship between in utero cocaine exposure and child behavioral functioning at age 7 years with ratings made by blinded examiners during a structured testing session. A second aim was to examine whether caregiver drug use and psychological problems might mediate suspected relationships between prenatal cocaine exposure and aspects of examiner-rated behavior.
Methods:
407 children (212 cocaine-exposed, 195 non-exposed) participating in the longitudinal Miami Prenatal Cocaine Study (MPCS) were rated with regard to their behavior during a neuropsychological assessment conducted at age 7 years. Raters were trained research psychometricians blinded to drug exposure status. Individual behavioral items were summarized and the cocaine-behavior relationship was estimated within the context of latent variable modeling, using Mplus software.
Results:
Two latent variables, Behavioral Regulation and Sociability, were derived via exploratory latent structure analysis with promax rotation. Prenatal cocaine exposure, statistically controlling for child sex, test age, and prenatal exposure to alcohol, tobacco, and marijuana, was associated with Behavioral Regulation (estimated slope ß=-0.25; 95% CI=-0.48, -0.02; p=0.04) but not Sociability (estimated slope ß=-0.03; 95% CI=-0.26, 0.20; p=0.79). Neither postnatal drug use by caregivers nor the severity of their psychological problems at age 5 follow-up predicted levels of child Behavioral Regulation or Sociability at age 7 years (p>0.10).
Conclusions:
Examiner ratings of child behavior at age 7 revealed less optimal behavioral regulation for prenatally cocaine-exposed compared to non-exposed children, in contrast with what had been previously found from parent-report data. This evidence highlights the potential value of trained observers in assessing behavioral outcomes of children exposed in utero to drugs and other toxicants.
