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Neuromotor development of cocaine-exposed and control infants from birth through 15 months: poor and poorer
1Boston University, Department of Physical Therapy, Massachusetts 02215, USA.
Insights
In utero cocaine exposure mildly impacts infant motor skills, with significant delays noted by 7 months. However, socioeconomic factors like poverty appear to be the primary drivers of poor motor development in both exposed and unexposed infants.
Area of Science:
- Developmental Pediatrics
- Neuroscience
- Public Health
Background:
- Prenatal exposure to substances like cocaine can impact infant development.
- Longitudinal studies are crucial for understanding the developmental trajectory of exposed infants.
- Socioeconomic factors significantly influence child development outcomes.
Purpose of the Study:
- To compare the motor development of infants exposed to cocaine in utero with a control group.
- To track motor development longitudinally from 1 to 15 months of age.
- To identify factors influencing motor performance in at-risk infants.
Main Methods:
- A cohort of 28 in utero cocaine-exposed infants and 22 unexposed controls were recruited.
- Infants were assessed using the Alberta Infant Motor Scale (AIMS), Movement Assessment of Infants (MAI), and Peabody Developmental Motor Scales (PDMS) at various ages (1, 4, 7, 15 months).
- Demographic, medical, and social risk factors were assessed.
Main Results:
- Exposed infants showed poorer motor performance at 4 and 7 months on AIMS and MAI compared to controls.
- No significant differences were found at 1 or 15 months, but both groups scored below expected norms.
- High levels of risk factors associated with poverty were prevalent in all participants, irrespective of cocaine exposure.
Conclusions:
- In utero cocaine exposure has a modest effect on motor development, primarily observed later in infancy.
- Poor motor performance in this cohort is strongly linked to cumulative risk factors, particularly those related to poverty.
- Interventions addressing socioeconomic disparities are critical for improving motor outcomes in at-risk infants.
Objective:
The objective of this study is to describe the longitudinal course of motor development of a group of infants exposed to cocaine in utero and an unexposed control group.
Methods:
Subjects included 28 in utero-exposed infants and 22 unexposed infants matched for race, income of the family, and mother's educational level. Infants were evaluated at 1 month with the Alberta Infant Motor Scale (AIMS), at 4 months with the AIMS and Movement Assessment of Infants (MAI), at 7 months with the AIMS and MAI, and at 15 months with the Peabody Developmental Motor Scales (PDMS).
Results:
At 4 months, compared with the unexposed infants, a significantly larger proportion of the exposed infants fell below the 50th percentile on the AIMS and had greater proportion of suspicious risk scores on the MAI. At 7 months infants in the exposed group had lower AIMS and MAI scores than the control group. There was no difference between groups on the motor scales at 1, 4, or 15 months. At all ages more infants in both groups scored significantly less than the expected norms on all scales. Performance was unrelated to a cumulative risk index made up of demographic, medical, and social factors. Almost all subjects had risk scores that placed them at extremely high levels of risk. Performance may have been related to a difference in weight between groups at 7 months and to decreasing weights for both groups by 15 months.
Conclusion:
In utero cocaine exposure has a significant, although relatively small, effect on infant motor performance late in infancy. However, regardless of exposure status, these infants had poor performance that may be accounted for by a heavy accumulation of risk factors associated with poverty.