Abstract 70
Poster Session III, Monday, 5/3 (poster 357)
Prenatal cocaine exposure has been associated with neonatal behavior changes. More recently a dose-response relationship has been identified. However, little data are available to address the long-term behavioral effects. The aim of this report is to evaluate the school age behavior of children prenatally-exposed to cocaine. Study subjects are singleton infants born to women extensively screened by research staff during pregnancy for alcohol, cigarette, cocaine and other drug use. As indicated, maternal and infant drug testing was performed. Cocaine exposure (CEXP) was positive if history or lab was positive. Six years later, 730 families were contacted; 93% agreed to testing. Six percent failed to keep multiple appointments. Following informed consent, the child, primary caretaker (PARENT) and, when available, the biologic mother were tested in our research facilities. Testing included: PARENT self-reported psychopathology (SCL-90). PARENT reported social support (Norbeck), a modified HOME assessment, family socioeconomic status (Hollingshead), and the child's self-report of exposure to violence (Things I Have Seen and Heard). Permission was given to obtain blinded teacher assessments of child behavior with the Achenbach Teacher Report Form (TRF). Drug use since the child's birth was assessed by trained researchers using a structured interview. For this report, children whose mothers were HIV positive were excluded. Results: Mothers of CEXP children were older and had more prenatal exposure to cigarettes, alcohol, and other illicit substances than controls (all p values <.001). CEXP children weighed less at birth and had lower gestational age (p<0.001). Testing was available at age 6 for 560 parent-children dyads (240 CEXP). CEXP was highly correlated with postnatal cocaine use in the child's home, however, urine testing of 150 children failed to identify a single child positive for cocaine at follow-up. PARENT-child testing was available for 560 children (240 CEXP). CEXP was highly correlated with postnatal cocaine use in the child's home, however, urine testing of 150 children failed to identify a single child positive for cocaine at follow-up. A comparison of relative externalizing (EXT: aggression, delinquency) to internalizing (INT: depression) behaviors was computed by taking the difference between the two subscales. All analyses were stratified by gender. After controlling for other prenatal substance exposures and PARENT variables, CEXP boys had higher EXT-INT scores (p<.01). In contrast, EXT-IN scores in girls were related to PARENT self-reported psychopathology (p=.02). Preliminary results of this NIDA funded study suggest gender-specific behavioral effects related to prenatal cocaine exposure. Causality, however, has not been demonstrated. It remains possible that other, unmeasured postnatal characteristics of the cocaine-using household may play a role in these important behavioral effects.
