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The effect of prenatal methamphetamine exposure on attention as assessed by continuous performance tests: results
Zeina N Kiblawi1, Lynne M Smith, Linda L LaGasse
1LA BioMed Institute, Harbor-UCLA Medical Center, David Geffen School of Medicine, Los Angeles, CA 90502, USA.
Insights
Prenatal methamphetamine exposure may increase attention-deficit hyperactivity disorder (ADHD) risk. Children exposed in utero showed subtle performance differences on a cognitive test, indicating potential ADHD indicators at age 5.5.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Prenatal substance exposure is a significant concern for child development.
- Methamphetamine use during pregnancy can have lasting neurodevelopmental consequences.
- Early identification of risks for attention-deficit hyperactivity disorder (ADHD) is crucial.
Purpose of the Study:
- To investigate the association between prenatal methamphetamine exposure and the risk of ADHD in young children.
- To evaluate cognitive performance in children with documented prenatal methamphetamine exposure.
- To identify early indicators of ADHD in this vulnerable population.
Main Methods:
- Longitudinal study (Infant Development, Environment, and Lifestyle - IDEAL) of 412 mother-infant pairs.
- Identified 204 methamphetamine-exposed infants and 208 controls using self-report and meconium analysis.
- Administered the Conners' Kiddie Continuous Performance Test (K-CPT) to 301 children at 5.5 years of age.
Main Results:
- No significant differences in basic K-CPT measures like errors or reaction time.
- Methamphetamine-exposed children showed increased reaction time variability and slope.
- Increased likelihood (OR 3.1) of a positive ADHD confidence index score in the exposed group.
Conclusions:
- Prenatal methamphetamine exposure is linked to subtle neurocognitive differences in children at 5.5 years.
- These differences suggest an elevated risk for developing ADHD.
- Children with prenatal methamphetamine exposure require ongoing monitoring for ADHD symptoms.
Objective:
To assess for the increased risk of attention-deficit hyperactivity disorder (ADHD) in young children with prenatal methamphetamine exposure from the multicenter, longitudinal Infant Development, Environment, and Lifestyle (IDEAL) study.
Methods:
The IDEAL study enrolled 412 mother-infant pairs at 4 sites (Tulsa, OK; Des Moines, IA; Los Angeles, CA; and Honolulu, HI). Methamphetamine-exposed subjects (n = 204) were identified by self-report and/or gas chromatography/mass spectrometry confirmation of amphetamine and metabolites in infant meconium. Matched subjects (n = 208) denied methamphetamine use and had a negative meconium screen. This analysis included a subsample of 301 subjects who were administered the Conners' Kiddie Continuous Performance Test (K-CPT) at 5.5 years of age (153 exposed and 148 comparison). Hierarchical linear models adjusted for covariates tested exposure effects on K-CPT measures. Using the same covariates, logistic regression was used to determine the effect of exposure on the incidence of a positive ADHD confidence index score, defined as greater than 50%.
Results:
There were no differences between the groups in omission or commission errors or reaction time for correct trials. However, methamphetamine exposure was associated with subtle differences in other outcomes predictive of ADHD, including increased slope of reaction time across blocks (p < .001), increased variability in reaction time with longer interstimulus intervals (p < .01), and increased likelihood of greater than 50% on the ADHD confidence index (odds ratio, 3.1; 95% confidence interval, 1.2-7.8; p = .02).
Conclusion:
Prenatal methamphetamine exposure was associated with subtle differences in K-CPT scores at 5.5 years of age. Even at this relatively young age, these children exhibit indicators of risk for ADHD and warrant monitoring.
