Nwando Eze1, Lynne M Smith2, Linda L LaGasse3, Chris Derauf4, Elana Newman5, Amelia Arria6, Marilyn A Huestis7, Sheri A Della Grotta3, Lynne M Dansereau3, Charles Neal4, Barry M Lester3. 1. Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles (UCLA) and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA. 2. Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles (UCLA) and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA. Electronic address: smith@labiomed.org. 3. Pediatrics Division, Brown Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI. 4. John A. Burns School of Medicine, University of Hawaii, Honolulu, HI. 5. Department of Psychology, The University of Tulsa, Tulsa, OK. 6. Center for Substance Abuse Research, University of Maryland, College Park, MD. 7. Section on Chemistry and Drug Metabolism, National Institute on Drug Abuse, Bethesda, MD.
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 Infant Development, Environment, and Lifestyle 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 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 < .001) and with increased externalizing, rule-breaking behavior, and aggressive behavior (P < .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. CONCLUSIONS: 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.
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 Infant Development, Environment, and Lifestyle 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 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 < .001) and with increased externalizing, rule-breaking behavior, and aggressive behavior (P < .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. CONCLUSIONS: 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.
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