School-Aged Outcomes following Prenatal Methamphetamine Exposure: 7.5-Year Follow-Up from the Infant Development, Environment, and Lifestyle Study

Abstract

Objective To assess the relationship between prenatal methamphetamine exposure (PME) and behavior problems at age 7.5 years, and the extent to which early adversity mediated this relationship. Study design The multicenter, longitudinal IDEAL study enrolled 412 mother-infant pairs at 4 sites. Methamphetamine-exposed participants (n= 204) were identified by self-report and/or gas chromatography/mass spectrometry confirmation of amphetamine and metabolites in infant meconium. Matched participants (n = 208) denied methamphetamine use and had a negative meconium screen. At the 7.5 year follow-up, 290 children with complete Child Behavior Checklist (CBCL) data and an early adversity index score were available for analysis (n=146 exposed). Results PME was significantly associated with an increased early adversity index score (P<0.001) and with increased externalizing, rule-breaking behavior, and aggressive behavior (P<0.05). Early adversity was also associated with higher externalizing behavior scores. Early adversity significantly mediated the relationship between PME and behavioral problems. After adjusting the mediation model for sex, prenatal tobacco, alcohol, and marijuana exposures, and study site, the association of PME with early adversity remained significant. Conclusion Though PME is associated with behavioral problems, early adversity may be a strong determinant of behavioral outcome for children exposed to methamphetamine in utero. Early adversity significantly mediated the relationship between PME and behavioral problems.

Treatment of opioid withdrawal in neonates with morphine, phenobarbital, or chlorpromazine: a randomized double-blind trial

“…The exact mechanism needs to be elucidated. We would not recommend giving amphetamines to pregnant women consuming opioids in order to shorten neonatal abstinence syndrome, since the short-term and long-term adverse effects of prenatal amphetamine exposure are well documented in both, animal studies and human observational studies, including behavior problems at school age [7].…”

Teratogen update: Amphetamines

“…There were no test differences when comparing some versus no methamphetamine use during pregnancy. At 7.5 years of age, children were evaluated by caregivers using the Child Behavior Checklist and by an index of early life adversity based on study records (Eze et al, 2016). Prenatal methamphetamine exposure was associated with more early life adversity, extreme poverty, and change in caregiver.…”

Drogenabusus in der Schwangerschaft – Risiko für das Kind

“…Im Alter von 6 Jahren zeigten die Kinder nach pränataler Methamphetamin-Exposition eine signifikante Prädisposition zur Entwicklung eines ADHS. Im Alter von 7,5 Jahren wurden bei umfassenden Nachuntersuchungen ausgeprägte Verhaltensauffälligkeiten bei Kindern nach pränataler Methamphetamin-Exposition beobachtet [25,26]. In der eigenen Arbeitsgruppe mussten wir feststellen, dass die ständig wachsende Rate an Crystal Meth konsumierenden Schwangeren eine Zuspitzung der Situation bedeutet.…”