Prenatal Exposure to Cocaine and Other Drugs: Outcome at Four to Six Years<sup>a</sup>

Chasnoff, Ira J.; Anson, Amy; Hatcher, Roger P.; Stenson, Herb; Iaukea, Kai; Randolph, Linda

doi:10.1111/j.1749-6632.1998.tb09748.x

Cited by 105 publications

(77 citation statements)

References 31 publications

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“…A number of studies have found poor pregnancy and neonatal outcomes among women who used alcohol or illegal drugs during pregnancy, [1][2][3][4] and the long-term impact of prenatal alcohol or illicit drug exposure on the development and behavior of the exposed child [5][6][7][8] is now being documented. However, despite the concern over the consequences of prenatal exposure to alcohol and other drugs, substance use by the pregnant woman remains a frequently missed diagnosis.…”

Section: Introductionmentioning

confidence: 99%

The 4P's Plus© Screen for Substance Use in Pregnancy: Clinical Application and Outcomes

et al. 2005

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Determine the prevalence of substance use among pregnant women in five diverse communities utilizing the 4P's Plus r screen for alcohol, tobacco, and other drug use. STUDY DESIGN:Pregnant women enrolled in prenatal care clinics in five communities were screened for substance use with the 4P's Plus r . Those women with a positive screen underwent an assessment for substance use through a follow-up structured clinical interview conducted at the same prenatal visit. RESULTS:Among 7818 women in five communities, 2555 (32.7%) had a positive screen for substance use in pregnancy. Four of the communities conducted a follow-up assessment on all women with a positive screen (n ¼ 1548). Among these women, 717 (15% of the total population) had continued use after learning of the pregnancy. Overall, 21% of the pregnant women used alcohol prior to recognition of the pregnancy, and 11% continued use after knowledge of the pregnancy. Among the 512 women who continued to use alcohol, 2% were drinking daily, 7% were drinking 3 to 6 days per week, 27% were drinking 1 to 2 days per week, and 63% were drinking less than 1 day per week. The rates of marijuana use and other illicit drug use among the women were 7 and 2%, respectively, prior to knowledge of pregnancy and dropped to 3 and 1% after learning of the pregnancy. CONCLUSION:The 4P's Plus r identifies not only those pregnant women whose drinking or drug use is at a high enough level to impair daily functioning, but provides an opportunity for early intervention for the much larger group of women whose pregnancies are at risk from relatively small amounts of substance use.

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Section: Introductionmentioning

confidence: 99%

The 4P's Plus© Screen for Substance Use in Pregnancy: Clinical Application and Outcomes

et al. 2005

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“…Maternal use of alcohol, tobacco, (Chasnoff et al, 1998). Although the highly publicized phenomenon of "crack babies" might lead one to view prenatal cocaine exposure as a major contributor to the SES disparities noted here, there is little evidence that it plays a role.…”

Section: U N C O R R E C T E D P R O O Fmentioning

confidence: 84%

Mind, Brain, and Education in Socioeconomic Context

Farah

2010

The Developmental Relations Among Mind, Brain and Education

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“…Some investigators have found no associations between PDE and cognitive performance, 1,2 play behavior, 3 academic achievement, 2,4 attention, or teacher-rated classroom behavior. 2 In contrast, others have found associations between PDE and behavior problems, 1,5 symptoms of oppositional defiant disorder and ADHD, 6 aggression, 7 task persistence and attention problems, 8,9 and language performance. 10 The inconsistent findings may be partially attributed to methodological inconsistencies and to failure to control for confounders, ranging from prenatal tobacco and alcohol exposure, [11][12][13][14] to parental and family variables, such as mental health, education, intelligence, and income.…”

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confidence: 90%

Children's Cognitive-Behavioral Functioning at Age 6 and 7: Prenatal Drug Exposure and Caregiving Environment

Nair

Black

Ackerman

et al. 2008

Ambulatory Pediatrics

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Objectives-To examine how prenatal drug exposure (PDE) and the caregiving environment relate to cognitive, academic, and behavioral performance at ages 6 and 7.Methods-A longitudinal follow-up was conducted of 111 children with PDE and a community cohort (CC) of 62 non-drug-exposed children. Children completed standardized tests of cognition (Stanford-Binet IV, SB-IV) and academic performance (Wide Range Achievement Test-3, WRAT-3). Caregivers completed ratings of child behavior problems (Child Behavior Checklist, CBCL).Analysis-Multivariate analyses were conducted adjusting for gender, prenatal tobacco exposure, number of caregiver placement changes, and three caregiver variables assessed at age 7 including depressive symptoms, employment status, and public assistance status.Results-After adjusting for perinatal and environmental variables, there were no significant exposure group differences in cognition, academic performance, or behavior problems. In comparison with males, females had higher scores on overall IQ and 4 of 8 SB-IV subtests, fewer caregiver-reported attention and aggression problems, and higher reading achievement scores. There were no significant gender by group interactions.Conclusion-When analyses were adjusted for perinatal and environmental variables, most associations between PDE and cognitive-behavioral functioning were attenuated. Regardless of drug exposure history, males performed more poorly than females on multiple cognitive-behavioral indices. Both exposed and non-exposed children were from low-income families and obtained scores substantially below normative expectations, demonstrating the insidious effects of poverty on children's development. Keywordsprenatal drug exposure; school age children; gender; low-income Correspondence: Prasanna Nair, 737 West Lombard Street, Room 116, Baltimore Maryland, 21201, 410-706-5289 (phone), 410-706-0653 (fax), (pnair@peds.umaryland.edu). None of the authors has a conflict of interest.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Drug abuse among women of child-bearing age is a serious public health problem. Most of the research on the effects of prenatal drug exposure (PDE) has been conducted among young children; findings on performance during the school-age years have been mixed. Some investigators have found no associations between PDE and cognitive performance, 1,2 play behavior, 3 academic achievement, 2,4 attention, or teacher-rated classroom behavior. 2 In contrast, others have found associations between PDE and behavior problems, 1,5 symptoms of oppositional defiant disorder and ADHD, 6...

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Prenatal Exposure to Cocaine and Other Drugs: Outcome at Four to Six Years^a

Cited by 105 publications

References 31 publications

The 4P's Plus© Screen for Substance Use in Pregnancy: Clinical Application and Outcomes

The 4P's Plus© Screen for Substance Use in Pregnancy: Clinical Application and Outcomes

Mind, Brain, and Education in Socioeconomic Context

Children's Cognitive-Behavioral Functioning at Age 6 and 7: Prenatal Drug Exposure and Caregiving Environment

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Prenatal Exposure to Cocaine and Other Drugs: Outcome at Four to Six Yearsa

Cited by 105 publications

References 31 publications

The 4P's Plus© Screen for Substance Use in Pregnancy: Clinical Application and Outcomes

The 4P's Plus© Screen for Substance Use in Pregnancy: Clinical Application and Outcomes

Mind, Brain, and Education in Socioeconomic Context

Children's Cognitive-Behavioral Functioning at Age 6 and 7: Prenatal Drug Exposure and Caregiving Environment

Contact Info

Product

Resources

About

Prenatal Exposure to Cocaine and Other Drugs: Outcome at Four to Six Years^a