The effects of prenatal cocaine exposure and child outcome

Lester, Barry M.; Tronick, Edward Z.

doi:10.1002/1097-0355(199422)15:2<107::aid-imhj2280150203>3.0.co;2-r

Cited by 79 publications

(53 citation statements)

References 13 publications

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“…These core clusters of temperament include orientation, motor organization, range of state and regulation of state. The NBAS is the most widely employed neonatal assessment scale and has been used extensively to study risk factors, 19,20 the effects of obstetric medication and mode of delivery, 21,22 maternal substance abuse, [23][24][25] cross cultural effects 26 and as a predictor of later development. [27][28][29] The NBAS is also related to concurrent and later measures of temperament in infancy and early childhood.…”

Section: Discussionmentioning

confidence: 90%

Dopamine D4 receptor and serotonin transporter promoter in the determination of neonatal temperament

et al. 1998

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Genetic effects on behavior were evaluated at a time in early development when we hypothesized that environmental influences are minimal and least likely to confound associations between temperament and genes. The behavioral effects of two common polymorphisms linked respectively in some, but not all, studies to novelty seeking (dopamine D4 receptor -D4DR) and neuroticism and harm avoidance (serotonin transporter promoter region -STPR) were examined in a group of 81 two-week-old neonates. Neonate temperament was evaluated using the Brazelton neonatal assessment scale (NBAS). Multivariate tests of significance showed a significant association of D4DR across four behavioral clusters pertinent to temperament including orientation, motor organization, range of state and regulation of state. A significant multivariate interaction was also observed between D4DR and STPR. The effect of the homozygous short STPR genotype (s/s) was to lower the orientation score for the group of neonates lacking the long form (L) of D4DR. When adult subjects were grouped by the STPR polymorphism there is no significant effect of L-D4DR in those subjects homozygous for the STPR short form (s/s) whereas in the group without the homozygous genotype the effect of L-D4DR is significant and accounts for 13% of the variance in novelty seeking scores between groups.

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Section: Discussionmentioning

confidence: 90%

Dopamine D4 receptor and serotonin transporter promoter in the determination of neonatal temperament

et al. 1998

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“…One example is all the research triggered by the extensive cocaine problem that the United States has been struggling with. Because widespread use of cocaine was considered an "epidemic", considerable research on prenatal cocaine exposure and child outcomes was conducted (Lester & Tronick, 1994). Users frequently identified cocaine as their drug of choice, but most often polysubstance use was reported as well.…”

Section: Potential Confounding Factorsmentioning

confidence: 99%

Prenatal drug exposure and the conceptualization of long‐term effects

Moe

Slinning²

2002

Scandinavian J Psychology

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This paper discusses several factors affecting the development of children prenatally exposed to drugs. In the "first generation" of research in this field a main factor model of disease formed the basis for a belief in the feasibility of detecting the direct pharmacological or teratogenic effects of drug exposure on long-term child development. However, the clustering of confounding variables has constituted a major problem in identifying these effects. In the last few years a "second generation" of research in this field has emerged, and investigators have moved beyond simple main-effect models. The importance of controlling for confounding variables has been underscored. However, prenatal substance exposure is still often studied within a teratology model where the main goal is the search for unique effects of a specific drug or substance. Based on this review it is suggested that an appropriate model for understanding the development of drug-exposed children cannot be based on a main-effect perspective. Rather, such a model must evolve from a contextual perspective, and it is suggested that a transactional model, where both potential risk factors and protective factors are considered, should replace the traditional teratology model in this field.

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“…Learning difficulties, low attentive capacities and a higher degree of aggressiveness in preschool and school age (Cavazzuti, Frigieri, Finelli, 1987;Fundaro, Salvataggio, 1987;Oloffson, Buckley, 1983;Sanderegger, Zimmermann, 1978;Wilson, McCreary, Kean, Baxter, 1979) are also reported in these children, even if, compared to controls, neither differences in IQ levels nor alterations of intellectual functions are to be found (Azuma, Chasnoff, 1993). In this respect, Lester and Tronick (1994) offer an outlook on the effects of prenatal drug exposure which takes into consideration functional difficulties in the "4A" childhood areas (attention, arousal, affectivity and action). However, we should also remember the results of a research by Alessandri, Bendersky and Lewis (1998) revealing a correlation between the severity of the child's developmental deficit and the amount of substance (in their specific research, heroin) consumed by the mother during pregnancy.…”

Section: Endogenous Risk Factorsmentioning

confidence: 99%