Neonatal Neurobehavioral and Neuroanatomic Correlates of Prenatal Cocaine Exposure: Problems of Dose and Confounding

Frank, Deborah A.; Augustyn, Marilyn; Zuckerman, Barry

doi:10.1111/j.1749-6632.1998.tb09725.x

Cited by 43 publications

(16 citation statements)

References 54 publications

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“…30 Maternal self-report scales are low in cost, readily available, generally well standardized, and easily administered. 31 In the present study, more than one-third of the mothers admitted continued cocaine and/or heroin use. Although the validity of maternal self-report has been questioned, 30 the mothers in the present study may have felt more comfortable admitting ongoing drug use because of the continuity of the research team, and because all the mothers were admitted drug users.…”

Section: Discussionmentioning

confidence: 50%

Ongoing Maternal Drug Use, Parenting Attitudes, and a Home Intervention: Effects on Mother-Child Interaction at 18 Months

Schuler

Nair

Black

2002

Journal of Developmental & Behavioral Pediatrics

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This prospective study examined the effects of ongoing maternal drug use, parenting attitudes, and a home-based intervention on mother-child interaction among drug-using women and their children. At 2 weeks postpartum, mothers and infants were randomly assigned to either an Intervention (n = 67) or Control (n = 64) Group. Intervention families received weekly visits until 6 months postpartum and biweekly visits from 6 to 18 months by trained lay visitors. The home intervention was designed to increase maternal empowerment and promote child development. Control families received brief monthly tracking visits. Mother-child interaction was evaluated at 18 months through observation of play. Mothers who continued to use cocaine and/or heroin had lower competence scores (p < .05); poor parenting attitude was also associated with lower competence scores during mother-child interaction (p < .05). Although the intervention had no measured effect, ongoing maternal drug use and poor parenting attitudes were associated with less optimal maternal behavior during mother-child interaction.The focus of much of the research on drug-using mothers and their infants has been on the short-and long-term effects of prenatal drug exposure. However, recent research 1 indicates that developmental and behavioral outcomes once thought to be specific to prenatal cocaine exposure are actually associated with other factors, such as the quality of the child's environment. Drug-exposed children raised in homes with ongoing parental drug use are more likely to display problems in cognitive development than drug-exposed children raised in drug-free environments. 2,3 Women who continue to use drugs after the infants are born are often unable to provide a stable, consistent, nurturing environment for their children. [4][5][6] Maternal drug use is associated with higher parenting stress 7 and poorer parenting attitudes, 8,9 and poor parenting attitudes such as a belief in harsh discipline were associated with less optimal maternal behavior during a parent-child observation session. 10 Factors such as ongoing maternal drug use and poor parenting attitudes may be associated with less optimal maternal and child behavior during mother-child interaction among substanceabusing mothers and their drug-exposed children.Home-intervention programs have often been used with drug-using women and their children. Using community health nurses, one home-based program provided health education and a child-development curriculum over the first 12 months postpartum. 11 Although the number of home visits varied by family, the intervention led to better motherinfant interaction at 3 months postpartum. Another home-based program using community nurses provided a child-development curriculum and maternal support during biweekly home visits (mean number of visits = 12) over the first 18 months postpartum. 12 Infants in the Intervention Group had higher cognitive scores and a more stimulating and responsive Copyright © 2002 home environment in comparison with Con...

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Section: Discussionmentioning

confidence: 50%

Ongoing Maternal Drug Use, Parenting Attitudes, and a Home Intervention: Effects on Mother-Child Interaction at 18 Months

Schuler

Nair

Black

2002

Journal of Developmental & Behavioral Pediatrics

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“…Methodological differences between studies can also influence outcomes. These may include subject characteristics, demographics, and enrollment criteria; the specific covariates controlled in the analyses; the unknown purity and varying routes of administration and timing of use of the illegal drug during pregnancy; as well as the specific developmental outcomes tested [26], [72]. When evaluating potential IUCE effects, other factors such as, gender, IQ, and maternal education which influence cognitive outcomes of children in general must be addressed either by subject selection or statistical control [7], [56], [27], [51].…”

Section: Introductionmentioning

confidence: 99%

Intrauterine cocaine exposure and executive functioning in middle childhood

Rose-Jacobs

Waber

Beeghly

et al. 2009

Neurotoxicology and Teratology

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“…Findings from prior analyses in this cohort indicated that IUCE defined this way was significantly related in a linear dose-dependent manner to lower birth weight z -scores adjusted for gestational age and sex [45], less optimal patterns of newborn neurobehavior [136], and neonatal ultrasound findings [46]. This ordinal IUCE classification of the sample (unexposed, lighter exposed, heavier exposed), which was established at birth, was used as the primary predictor of NEPSY outcomes in the current analysis.…”

Section: Methodsmentioning

confidence: 99%

Level of intrauterine cocaine exposure and neuropsychological test scores in preadolescence: subtle effects on auditory attention and narrative memory

Rose-Jacobs

Martin

Cabral

et al. 2014

Neurotoxicology and Teratology

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Neuropsychological processes such as attention and memory contribute to children's higher-level cognitive and language functioning and predict academic achievement. The goal of this analysis was to evaluate whether level of intrauterine cocaine exposure (IUCE) alters multiple aspects of preadolescents' neuropsychological functioning assessed using a single age-referenced instrument, the NEPSY: A Developmental Neuropsychological Assessment (NEPSY) [71], after controlling for relevant covariates. Participants included 137 term 9.5-year-old children from low-income urban backgrounds (51% male, 90% African American/Caribbean) from an ongoing prospective longitudinal study. Level of IUCE was assessed in the newborn period using infant meconium and maternal report. 52% of the children had IUCE (65% with lighter IUCE, and 35% with heavier IUCE), and 48% were unexposed. Infants with Fetal Alcohol Syndrome, HIV seropositivity, or intrauterine exposure to illicit substances other than cocaine and marijuana were excluded. At the 9.5-year follow-up visit, trained examiners masked to IUCE and background variables evaluated children's neuropsychological functioning using the NEPSY. The association between level of IUCE and NEPSY outcomes was evaluated in a series of linear regressions controlling for intrauterine exposure to other substances and relevant child, caregiver, and demographic variables. Results indicated that level of IUCE was associated with lower scores on the Auditory Attention and Narrative Memory tasks, both of which require auditory information processing and sustained attention for successful performance. However, results did not follow the expected ordinal, dose-dependent pattern. Children's neuropsychological test scores were also altered by a variety of other biological and psychosocial factors.

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Neonatal Neurobehavioral and Neuroanatomic Correlates of Prenatal Cocaine Exposure: Problems of Dose and Confounding

Cited by 43 publications

References 54 publications

Ongoing Maternal Drug Use, Parenting Attitudes, and a Home Intervention: Effects on Mother-Child Interaction at 18 Months

Ongoing Maternal Drug Use, Parenting Attitudes, and a Home Intervention: Effects on Mother-Child Interaction at 18 Months

Intrauterine cocaine exposure and executive functioning in middle childhood

Level of intrauterine cocaine exposure and neuropsychological test scores in preadolescence: subtle effects on auditory attention and narrative memory

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