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Cocaine-exposed children: follow-up through 30 months
H Hurt1, N L Brodsky, L Betancourt
1Division of Neonatology, Albert Einstein Medical Center, Philadelphia, PA 19141, USA.
Insights
In utero cocaine exposure did not impact infant development scores in this study. However, low socioeconomic status significantly influenced developmental outcomes for all children, regardless of drug exposure.
Area of Science:
- Pediatrics
- Neuroscience
- Public Health
Background:
- Prenatal exposure to substances, including cocaine, raises concerns about long-term child development.
- Socioeconomic factors are known to influence child development outcomes.
- Understanding the independent effects of prenatal cocaine exposure versus socioeconomic status is crucial for targeted interventions.
Purpose of the Study:
- To evaluate the effect of in utero cocaine exposure on growth, neurodevelopment, and reflexes in term and near-term infants.
- To compare outcomes between cocaine-exposed infants and a control group from low socioeconomic backgrounds.
- To investigate the influence of socioeconomic status on infant development.
Main Methods:
- Prospective, blinded study design with 219 infants (101 cocaine-exposed, 118 controls).
- Regular follow-up visits for 30 months, including growth measurements and natal evaluations.
- Assessment using Bayley Scales of Infant Development (BSID) and evaluation of tone and reflexes at 6 and 12 months.
Main Results:
- Cocaine-exposed children exhibited lower mean weights and head circumferences compared to controls (p < .011).
- No significant differences were found in abnormal tone/reflexes or BSID Mental/Psychomotor Development Index scores between groups (p > .16).
- Both groups showed declining BSID scores over time, and both scored lower than higher socioeconomic status children.
Conclusions:
- In this cohort, low socioeconomic status appeared to significantly influence infant development scores more than in utero cocaine exposure.
- Prenatal cocaine exposure did not demonstrate a significant impact on the measured developmental outcomes in this study.
- Further research is needed to elucidate the complex interplay between socioeconomic factors and developmental trajectories in children exposed to substances in utero.
Abstract:
This prospective, blinded study evaluates the effect of in utero cocaine exposure on outcome of nonasphyxiated, term and near-term children born to women of low socioeconomic status. Two hundred nineteen children (101 cocaine-exposed and 118 control) with extensive natal evaluations are evaluated at 6-month intervals. We report here growth, performance on the Bayley Scales of Infant Development (BSID) through 30 months of age, and tone and reflexes at 6 and 12 months. To date, subjects have had 816 follow-up visits, with subject retention greater than or equal to 73%. Cocaine-exposed children showed statistically lower mean weights and smaller mean head circumferences than control children over the 30-month follow-up period (p < or = .011). The percentage of children with abnormal tone and reflexes, however, was similar in the two groups at 6 and 12 months (p > or = .34). Mean BSID Mental Development Index (MDI) and Psychomotor Development Index scores did not differ between the two groups (p > or = .16), although both groups' scores decreased over time (p < .001). Of concern, both cocaine-exposed and control groups had lower mean MDI scores than those published for a group of children of higher socioeconomic status. We conclude that, in our cohort of children, low socioeconomic or minority status may have had a substantial influence on BSID scores whereas in utero drug exposure did not.