Growth of Infants Prenatally Exposed to Cocaine/Crack: Comparison of a Prenatal Care and a No Prenatal Care Sample

Richardson, Gale A.; Hamel, Sara C.; Goldschmidt, Lidush; Day, Nancy L.

doi:10.1542/peds.104.2.e18

Cited by 94 publications

(54 citation statements)

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“…In addition to the association between PCE and temperament that was identified in this study, we have previously reported that first trimester cocaine use was a significant predictor of reduced gestational age [73] and neurobehavioral and neurophysiological changes at birth [72,77]. Brain development during pregnancy is characterized by a complex interaction of genetic, neurochemical, and environmental factors [29].…”

Section: Discussionsupporting

confidence: 53%

“…Women were enrolled prenatally and interviewed about their drug use at the end of each trimester of pregnancy. At birth, infants who were exposed to cocaine prenatally were smaller and had reduced gestational age compared to those who were not exposed [73]. The exposed infants also had poorer autonomic stability, state regulation, and motor maturity on the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) at birth [72], and less mature brain development on EEG-sleep studies at both birth and 1 year of age [77].…”

Section: Discussionmentioning

confidence: 99%

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The effects of prenatal cocaine use on infant development

Richardson¹,

Goldschmidt²,

Willford³

2008

Neurotoxicology and Teratology

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This study examined the effect of prenatal cocaine use on infant physical, cognitive, and motor development, and temperamental characteristics, controlling for other factors that affect infant development. Women were, on average, 26.8 years old, had 12 years of education, and 46% were African American. During the first trimester, 18% were frequent users of cocaine (≥ 1 line/day). The infants were, on average, 14.6 months old at this follow-up phase. Women who used cocaine during pregnancy rated their infants as more fussy/difficult and unadaptable than did women who did not use cocaine. Cocaine use in the second trimester was associated with significantly lower motor scores on the Bayley Scales of Infant Development (BSID) [9]. There was no effect of prenatal cocaine use on BSID mental performance or on growth. These findings are consistent with other reports in the literature and with the hypothesis that prenatal cocaine exposure affects development through changes in neurotransmitter systems.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

The effects of prenatal cocaine use on infant development

Richardson¹,

Goldschmidt²,

Willford³

2008

Neurotoxicology and Teratology

Self Cite

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“…Research on prenatal malnutrition indicates that growth of brain structures, and therefore head size, recover after nutritional rehabilitation [23], providing an explanation for why head circumference in this cohort may have been affected by cocaine at birth but not at 6 years. While lower growth parameters have been found consistently for prenatally cocaine-exposed children when evaluating outcomes at birth [4,5,9,12,31,36], findings for long-term growth outcomes to age 7 are inconclusive [11,30].…”

Section: Discussionmentioning

confidence: 99%

“…Related to fetal growth however, there are consistent findings indicating that after consideration of a large number of covariates, prenatal cocaine exposure has specific effects on infant birth parameters including head circumference, weight and length [4,5,9,11,12,31,37,41]. Growth deficits are believed to result from poor maternal nutrition, restricted placental blood flow or some other unknown mechanism.…”

Section: Introductionmentioning

confidence: 99%

Dysmorphic and anthropometric outcomes in 6-year-old prenatally cocaine-exposed children

Minnes

Robin

Alt

et al. 2006

Neurotoxicology and Teratology

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Dysmorphologic and anthropometric assessments were performed on 154 6-year-old children prenatally exposed to cocaine (PCE) and 131 high-risk controls (NCE) of similar race and social class. Adjusted mean height z scores demonstrated a dose-response with metahydroxybenzoylecgonine above a threshold of 100 ng/g of meconium and greater cocaine exposure predicted lower weight for height z score. Higher average alcohol exposure throughout pregnancy and 3rd trimester predicted lower head circumference and weight z scores, respectively. Severity of marijuana use also predicted lower height for age but greater weight for height. There was not an increased rate of minor anomalies among the PCE cohort, nor was a consistent phenotype identified. After controlling for covariates, higher average prenatal cigarette exposure predicted higher incidence of cranial facial abnormalities. First trimester alcohol exposure predicted greater rates of ear abnormalities and third trimester marijuana exposure predicted greater rates of chest and head shape abnormalities. These finding indicate that prenatal cocaine exposure has a negative effect on specific growth outcomes including standardized height and weight for height, but not a systematic pattern of structural abnormalities.

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“…[7][8][9][10][11][12][13] The timing and amount of fetal exposure to cocaine, tobacco, and alcohol during pregnancy also have been noted to influence birth weight. 2,10,11,14 Infants born to women who stopped smoking had higher birth weights than did those born to women who reduced smoking or who did not change behavior. 10,11 Infants born to women who drank throughout pregnancy had smaller head sizes than did those born to women who stopped drinking in the second trimester or who did not drink during pregnancy.…”

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confidence: 99%

Association Between Patterns of Maternal Substance Use and Infant Birth Weight, Length, and Head Circumference

et al. 2004

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ABSTRACT. Objective. To determine the effects of patterns of drug use during term pregnancy on infant growth parameters at birth.Methods. Histories of cocaine, opiate, alcohol, tobacco, and marijuana use during the 3-month period before pregnancy and the 3 trimesters of pregnancy were recorded at the infants' 1-month visit. Patterns of use were categorized as consistently high, moderate, or low/ none or increasing/decreasing, and effects on growth parameters were analyzed in multivariate linear regression analyses, with adjustment for clinical site, maternal age, prepregnancy weight, multidrug use, and socioeconomic status.Results. A total of 241 cocaine-exposed women and 410 non-cocaine-exposed women participated in the study. In the cocaine-exposed group, 75% used alcohol, 90% used tobacco, and 53% used marijuana; in the noncocaine-exposed group, 57% used alcohol, 34% used tobacco, and 19% used marijuana. Birth weight, birth length, and head circumference were significantly greater among infants born to women who used no drugs, compared with women with any cocaine, opiate, alcohol, tobacco, or marijuana use, and were greater among infants born to cocaine nonusers, compared with cocaine users. With adjustment for confounders, birth weight was significantly affected by cocaine (deficit of 250 g with consistently low pattern) and tobacco (deficits of 232 g with consistently high pattern, 173 g with consistently moderate pattern, 153 g with decreasing pattern, and 103 g with consistently low pattern). Head size was affected by cocaine (deficit of 0.98 cm with consistently moderate pattern) and tobacco (deficits of 0.72 cm with consistently high pattern and 0.89 cm with consistently moderate pattern). Birth length was affected by tobacco use only (deficits of 0.82 cm with consistently high pattern and 0.98 cm with decreasing use).Conclusion. Patterns of tobacco use during pregnancy affect birth weight, length, and head circumference, whereas cocaine affects birth weight and head size, when adjustments are made for confounders, including multidrug use. Pediatrics 2004;114:e226 -e234. URL: http: //www.pediatrics.org/cgi/content/full/114/2/e226; prenatal, cocaine, alcohol, tobacco, marijuana, infant birth weight, length, head circumference.ABBREVIATIONS. MISU, Maternal Inventory of Substance Use. M aternal cocaine use during pregnancy has been associated with decreased growth parameters at birth for infants. [1][2][3][4][5] Women who use cocaine during pregnancy are often exposed to many drugs, including alcohol and tobacco, 1-6 both of which have been shown to have effects on birth weight in studies evaluating the use of these substances alone or in combination. [7][8][9][10][11][12][13] The timing and amount of fetal exposure to cocaine, tobacco, and alcohol during pregnancy also have been noted to influence birth weight. 2,10,11,14 Infants born to women who stopped smoking had higher birth weights than did those born to women who reduced smoking or who did not change behavior. 10,11 Infants born to women who drank ...

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Growth of Infants Prenatally Exposed to Cocaine/Crack: Comparison of a Prenatal Care and a No Prenatal Care Sample

Cited by 94 publications

References 53 publications

The effects of prenatal cocaine use on infant development

The effects of prenatal cocaine use on infant development

Dysmorphic and anthropometric outcomes in 6-year-old prenatally cocaine-exposed children

Association Between Patterns of Maternal Substance Use and Infant Birth Weight, Length, and Head Circumference

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