Intrauterine Growth of Full-Term Infants: Impact of Prenatal Cocaine Exposure

Bandstra, Emmalee S.; Morrow, Connie E.; Anthony, James C.; Churchill, Shervin S.; Chitwood, Dale C.; Steele, Bernard W.; Ofir, Audrey Y.; Xue, Ling

doi:10.1542/peds.108.6.1309

Cited by 76 publications

(50 citation statements)

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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%

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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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Section: Discussionmentioning

confidence: 99%

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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“…A disproportionate adverse effect on head growth at birth, compared with overall growth or birth weight, was noted by some investigators 20 but not others. 30,31 The majority of studies that evaluated the effects of drug use on fetal growth compared the outcomes for exposed and unexposed infants without evaluating the confounding effects of prematurity or timing of use during pregnancy. 16,21 We focused our study only on women with term gestation, because cocaine and tobacco use are associated with preterm delivery.…”

Section: Discussionmentioning

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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“…The overall study design for the longitudinal Miami Prenatal Cocaine Study, briefly summarized below, has been extensively detailed in an earlier report (Bandstra et al, 2001b). As part of a larger epidemiological study, 476 mother-infant dyads were enrolled prospectively into a follow-up cohort to evaluate the effects of prenatal cocaine exposure on long-term developmental outcome.…”

Section: Methodsmentioning

confidence: 99%

“…Fetal growth was measured by a latent construct including birth weight, length, and head circumference, all of which are intercorrelated manifestations of a fetal growth process that has been previously shown to be responsive to prenatal cocaine exposure (Bandstra et al, 2001b). Fetal maturation was measured by gestational age.…”

Section: Severity Of Prenatalmentioning

confidence: 99%

Severity of Prenatal Cocaine Exposure and Child Language Functioning Through Age Seven Years: A Longitudinal Latent Growth Curve Analysis

Bandstra

Vogel

Morrow

et al. 2004

Substance Use & Misuse

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The current study estimates the longitudinal effects of severity of prenatal cocaine exposure on language functioning in an urban sample of full-term African-American children (200 cocaineexposed, 176 noncocaine-exposed) through age 7 years. The Miami Prenatal Cocaine Study sample was enrolled prospectively at birth, with documentation of prenatal drug exposure status through maternal interview and toxicology assays of maternal and infant urine and infant meconium. Language functioning was measured at ages 3 and 5 years using the Clinical Evaluation of Language Fundamentals-Preschool (CELF-P) and at age 7 years using the Core Language Domain of the NEPSY: A Developmental Neuropsychological Assessment. Longitudinal latent growth curve analyses were used to examine two components of language functioning, a more stable aptitude for language performance and a time-varying trajectory of language development, across the three time points and their relationship to varying levels of prenatal cocaine exposure. Severity of prenatal cocaine exposure was characterized using a latent construct combining maternal self-report of cocaine use during pregnancy by trimesters and maternal and infant bioassays, allowing all available information to be taken into account. The association between severity of exposure and language functioning was examined within a model including factors for fetal growth, gestational age, and IQ as intercorrelated response variables and child's age, gender, and prenatal alcohol, tobacco, and marijuana exposure as covariates. Results indicated that greater severity of prenatal cocaine exposure was associated with greater deficits within the more stable aptitude for language performance (D = −0.071, 95% CI = −0.133, −0.009; p = 0.026). There was no relationship between severity of prenatal cocaine exposure and the time-varying trajectory of language development. The observed cocaineassociated deficit was independent of multiple alternative suspected sources of variation in language performance, including other potential responses to prenatal cocaine exposure, such as child's intellectual functioning, and other birth and postnatal influences, including language stimulation in the home environment.

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Intrauterine Growth of Full-Term Infants: Impact of Prenatal Cocaine Exposure

Cited by 76 publications

References 40 publications

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

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

Severity of Prenatal Cocaine Exposure and Child Language Functioning Through Age Seven Years: A Longitudinal Latent Growth Curve Analysis

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