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Long-Term Neurodevelopmental Risks in Children Exposed in Utero to Cocaine: The Toronto Adoption Studya
Gideon Koren1, Irena Nulman1, Joanne Rovet1
1Motherisk Program, bDivisions of Clinical Pharmacology and dPsychology Research, b,dThe Research Institute; The Hospital for Sick Children, and b,c,dDepartment of Pediatrics, Pharmacology University of Toronto, Toronto, Ontario, CanadaPsychology, University of Toronto, Toronto, Ontario, CanadaFaculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Abstract:
Children exposed in utero to cocaine are at risk for long-term neurobehavioral damage not just because of the drug itself, but also because of clustering of other health determinants, including low socioeconomic status, low maternal education, and maternal addiction, to mention a few. One methodologic approach to separate the direct neurotoxic effects of cocaine from these synergistic insults is to follow up a cohort of children exposed in utero to cocaine and given up for adoption to middle-upper class families. The Toronto Adoption Study, supported by Health Canada, has proven the direct neurotoxic effects of cocaine on IQ and language. These effects are mild to moderate as compared to those measured in children exposed in utero to cocaine and reared by their natural mothers.
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