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Cocaine-exposed infants (Family Law)

Tue, 01 Jun 2004 16:01:00 GMT
Tags: 1677etoc, aappublications, abstract, behavioral, cgi, cocaine-exposed, cognitive, content, family, http, infants, law, lifestyle, maternal, motor, org, outcomes, pediatrics

http://pediatrics.aappublications.org/cgi/content/abstract/113/6/1677?etoc

The Maternal Lifestyle Study: Cognitive, Motor, and Behavioral Outcomes of
Cocaine-Exposed and Opiate-Exposed Infants Through Three Years of Age

Objective. To evaluate the direct effects of prenatal cocaine exposure and
prenatal opiate exposure on infant mental, motor, and behavioral outcomes
longitudinally between 1 and 3 years old. Methods. As part of a prospective,
longitudinal, multisite study, the Bayley Scales of Infant Development II were
administered to 1227 infants who were exposed to cocaine (n = 474), opiates (n
= 50), cocaine and opiates (n = 48), and neither substance (n = 655) at 1, 2,
and 3 years of corrected age by certified, masked examiners. Hierarchic linear
modeling of the 1-, 2-, and 3-year scores was conducted using cocaine and
opiate exposure as predictors with and without controlling for covariates.

Results. Overall retention was 88.4% and did not differ by cocaine or opiate
exposure. Overall (at 1, 2, and 3 years), cocaine-exposed infants scored 1.6
Mental Development Index points below infants who were not exposed to cocaine.
Opiate-exposed infants scored 3.8 Psychomotor Development Index points below
infants who were not exposed to opiates. Neither the cocaine nor the opiate
effect remained significant after controlling for covariates. Neither cocaine
nor opiate exposure was associated with the Behavioral Record Score during the
examination. Low birth weight and indices of nonoptimal caregiving were
associated with lower Mental Development Index, Psychomotor Development Index,
and Behavioral Record Score scores for all groups of infants.

Conclusions. In the largest at-risk sample observed longitudinally to date,
infant prenatal exposure to cocaine and to opiates was not associated with
mental, motor, or behavioral deficits after controlling for birth weight and
environmental risks.

Daniel S. Messinger, PhD*, Charles R. Bauer, MD, Abhik Das, PhD, Ron Seifer,
PhD||, Barry M. Lester, PhD?, Linda L. Lagasse, PhD?, Linda L. Wright, MD##,
Seetha Shankaran, MD**, Henrietta S. Bada, MD, Vincent L. Smeriglio, PhD, John
C. Langer, PhD, Marjorie Beeghly, PhD|||| and W. Kenneth Poole, PhD

* Departments of Psychology and Pediatrics, University of Miami, Coral Gables,
Florida
University of Miami School of Medicine, Miami, Florida
Research Triangle Institute, Research Triangle Park, North Carolina
|| Brown University School of Medicine and Bradley Hospital, Providence, Rhode
Island
? Brown University School of Medicine, Women and Infant’s Hospital and
Bradley Hospital, Providence, Rhode Island
# National Institute of Child Health and Human Development, Bethesda, Maryland
** Wayne State University School of Medicine, Detroit, Michigan
University of Tennessee at Memphis, School of Medicine, Memphis, Tennessee
National Institute on Drug Abuse, Bethesda, Maryland
|||| Harvard Medical School, Harvard Medical School and Children’s Hospital,
Boston, Massachusetts

Key Words: cocaine ? opiates ? prenatal exposure ? BSID-II ? outcome

Abbreviations: BSID-II, Bayley Scales of Infant Development II ? MDI, Mental
Development Index ? PDI, Psychomotor Development Index ? SES, socioeconomic
status ? MLS, Maternal Lifestyle Study ? EMIT, enzyme-multiplied
immunoassay technique ? MISU, Maternal Inventory of Substance Use ? BE,
benzoylecgonine ? HOME, Home Observation for Measurement of the Environment
? PPVT-R, Peabody Picture Vocabulary Test-Revised ? BRS, Behavioral Rating
Scale ? HIV, human immunodeficiency virus

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