Prenatal exposure to cocaine and other drugs. Outcome at four to six years.

In a longitudinal, prospective study, 95 children born to mothers who used cocaine and other drugs during pregnancy and 75 matched, nonexposed children born to mothers who had no evidence of alcohol or illicit substance use during pregnancy were evaluated for cognitive and behavioral outcome at 6 years of age. Prenatal exposure to cocaine and other drugs had no direct effect on the child's cognitive outcome (measured as IQ), but it had an indirect effect as mediated through the home environment. However, prenatal exposure to cocaine and other drugs did have a direct effect on the child's behavioral characteristics at 4-6 years of age, with the home environment having little impact. This study helps us to understand the fragile interaction of biological and environmental factors affecting the cognitive and behavioral development of children prenatally exposed to cocaine and other drugs.