Prenatal exposure curbs cognitive development - Cocaine - medical research - Brief Article

USA Today (Society for the Advancement of Education), Oct, 2002

Scientists know the effects of cocaine on the adult brain and cardiovascular systems, but what about the effects of prenatal exposure on infants? A study by Case Western Reserve University School of Medicine, MetroHealth Medical Center, and University Hospitals of Cleveland (Ohio) followed 415 cocaine-exposed infants to determine how prenatal cocaine exposure affects child development outcomes. They were compared to nonexposed infants on cognitive and motor development until age two. Cocaine exposure does affect a child's cognitive development, but not motor development, they found.

Mothers and infants were recruited over a two-year period from a high-risk population screened for drug use. Urine samples were obtained immediately before and after labor and delivery, and analyzed for the presence of cocaine metabolites, cannabinoids, opiates, PCP, and amphetamines. Urine tests for drugs were performed on all women who received no prenatal care, appeared to be intoxicated or taking drugs, had a history with the Cleveland Department of Human Services in previous pregnancies, or self-admitted or appeared to be high risk for drug use according to interviews by hospital staff. Meconium was collected from infants' diapers and screened for drugs.

Researchers found that, for all trimesters, cocaine-using women availed themselves of alcohol, marijuana, and tobacco more frequently and in higher amounts than nonusers. Those who used cocaine were found to be older, had more children, and were less likely to have had prenatal care. They also were less likely to be married; had lower vocabulary, block design, and picture completion scores; and registered higher psychological distress scores. The study found that cocaine-exposed infants had lower gestational age, birthweight, head circumference, and length than nonexposed babies. There were more preterm, low-birthweight, and small-for-gestational-age infants in the exposed group. The rate of mental retardation in cocaine-exposed children at age two was 4.89 times higher than expected in the general population, while the percentage of youngsters with mild delays requiring intervention was almost double the rate of the high-risk noncocaine group.

Lynn Singer of the Case Western Reserve Department of Pediatrics cautions that the team is concerned that the study data will be misinterpreted and used to punish women or to remove children from their families. "Prosecution of women will not address the problems of alcohol and drug abuse. In fact, our study indicates that tobacco exposure also has significant negative effects on infant development. Our findings also indicate that the quality of stimulation and environmental intervention can have a large effect on children's mental development independent of cocaine or other drug exposure."