CONTEXT: Maternal use of cocaine during pregnancy remains a significant public health problem, particularly in urban areas of the United States and among women of low socioeconomic status. Few longitudinal studies have examined cocaine-exposed infants, however, and findings are contradictory because of methodologic limitations. OBJECTIVE: To assess the effects of prenatal cocaine exposure on child developmental outcomes. DESIGN: Longitudinal, prospective, masked, comparison birth cohort study with recruitment in 1994-1996. SETTING: Obstetric unit of a large US urban teaching hospital. PARTICIPANTS: Four hundred fifteen consecutively enrolled infants (218 cocaine-exposed and 197 unexposed) identified from a high-risk, low-socioeconomic status, primarily black (80%) population screened through clinical interview and urine and meconium samples for drug use. The retention rate was 94% at 2 years of age. MAIN OUTCOME MEASURES: The Bayley Mental and Motor Scales of Infant Development, assessed at 6.5, 12, and 24 months of corrected age. RESULTS: Controlled for confounding variables, cocaine exposure had significant effects on cognitive development, accounting for a 6-point deficit in Bayley Mental and Motor Scales of Infant Development scores at 2 years, with cocaine-exposed children twice as likely to have significant delay (mental development index <80) (odds ratio, 1.98; 95% confidence interval, 1.21-3.24; P =.006). For motor outcomes, there were no significant cocaine effects. CONCLUSIONS: Cocaine-exposed children had significant cognitive deficits and a doubling of the rate of developmental delay during the first 2 years of life. Because 2-year outcomes are predictive of later cognitive outcomes, it is possible that these children will continue to have learning difficulties at school age.
CONTEXT: Maternal use of cocaine during pregnancy remains a significant public health problem, particularly in urban areas of the United States and among women of low socioeconomic status. Few longitudinal studies have examined cocaine-exposed infants, however, and findings are contradictory because of methodologic limitations. OBJECTIVE: To assess the effects of prenatal cocaine exposure on child developmental outcomes. DESIGN: Longitudinal, prospective, masked, comparison birth cohort study with recruitment in 1994-1996. SETTING: Obstetric unit of a large US urban teaching hospital. PARTICIPANTS: Four hundred fifteen consecutively enrolled infants (218 cocaine-exposed and 197 unexposed) identified from a high-risk, low-socioeconomic status, primarily black (80%) population screened through clinical interview and urine and meconium samples for drug use. The retention rate was 94% at 2 years of age. MAIN OUTCOME MEASURES: The Bayley Mental and Motor Scales of Infant Development, assessed at 6.5, 12, and 24 months of corrected age. RESULTS: Controlled for confounding variables, cocaine exposure had significant effects on cognitive development, accounting for a 6-point deficit in Bayley Mental and Motor Scales of Infant Development scores at 2 years, with cocaine-exposed children twice as likely to have significant delay (mental development index <80) (odds ratio, 1.98; 95% confidence interval, 1.21-3.24; P =.006). For motor outcomes, there were no significant cocaine effects. CONCLUSIONS:Cocaine-exposed children had significant cognitive deficits and a doubling of the rate of developmental delay during the first 2 years of life. Because 2-year outcomes are predictive of later cognitive outcomes, it is possible that these children will continue to have learning difficulties at school age.
Authors: Julia S Noland; Lynn T Singer; Robert E Arendt; Sonia Minnes; Elizabeth J Short; Cynthia F Bearer Journal: Alcohol Clin Exp Res Date: 2003-04 Impact factor: 3.455
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Authors: Lynn T Singer; Laurie J Eisengart; Sonia Minnes; Julia Noland; Arthur Jey; Courtney Lane; Meeyoung O Min Journal: Infant Behav Dev Date: 2005-12
Authors: Sonia Minnes; Lynn T Singer; Meeyoung O Min; Adelaide M Lang; Aya Ben-Harush; Elizabeth Short; Miaoping Wu Journal: J Youth Adolesc Date: 2013-02-20