The purpose of this study was to determine the neurodevelopmental effects of gestational cocaine on inner city infants born at or near term without apparent medical complications. Cocaine exposed infants ≥ 36 weeks' gestation identified by biochemical screening were followed in a multidisciplinary clinic to 3 years of age. Non-cocaine exposed infants (by history and biochemical screening) matched by zip code of maternal residence were identified for comparison follow-up. At 6, 12, 24 and 36 months, infants were evaluated for psychomotor, language, developmental / intelligence quotients, growth parameters and social history. At 24 months, mothers were interviewed to determine emotional state (Beck Depression Inventory, BDI), family needs (modified Family Needs Survey), Family Support Scale, and Self Esteem Scale.
Cocaine using mothers were older (27± 5 and 22± 4 years), had greater parity, less likely to have received prenatal care, and had lighter birthweight infants(2.8± 0.4 and 3.2 ± 0.4 kg., p=.01). Cocaine infants were more likely to be hypertonic at birth but not different neurologically at 6 months. There were no group differences in developmental, psychomotor, or language quotients at 6, 12, or 24 months of age. There was no difference in mean IQ at 36 months (87.7± 9 and 87.9± 7, control and cocaine exposed, respectively). Compared to controls, cocaine exposed families had higher social risk scores and more likely to have protective services involved at 6, 12, and 24 months. More cocaine exposed infants were in foster care at 36 months than controls (32% and 7%, p=.01). Language quotients at 36 months were significantly related to family needs at 24 months, and inversely related to maternal depression by BDI. These data indicate that for infants≥36 weeks gestation with no apparent medical illness at birth following gestational cocaine exposure, measures of cognitition, motor and language performance to 36 months of age are not different from non-drug exposed infants. However, social risks and family needs are significantly greater in the cocaine exposed group. Addressing maternal psychosocial issues may have a significant impact on language scores for cocaine exposed infants.
