Document Detail

Cocaine exposure and developmental outcome from birth to 6 months.
MedLine Citation:
PMID:  12009484     Owner:  NLM     Status:  MEDLINE    
The theoretical framework for many of the early studies of prenatal cocaine exposure has been rooted in the basic concepts of teratology/developmental toxicology. Few have published longitudinal analyses of the complex interplay between the relative effects of prenatal cocaine exposure and perinatal and environmental factors on development. The purpose of this paper was to use structural equation modeling to describe the direct and indirect effects of prenatal drug exposure on developmental outcome from birth to age 6 months. Key variables considered for study include prenatal drug exposure, perinatal medical characteristics, maternal/caregiver/family characteristics, the home environment, and neurobehavioral outcomes. We prospectively enrolled 154 predominantly crack-using women. A priori exclusion criteria included: <18 years old, major illnesses diagnosed prior to pregnancy, chronic use of legal drugs, and any use of illicit drugs other than cocaine and marijuana. From the pool of noncocaine users, 154 subjects were matched to users on pregnancy risk, parity, race, and socioeconomic status. At the end of each trimester, experienced staff conducted private interviews prompting memory of amount and timing of past drug use. Urine specimens were collected at two unanticipated times; positive screens were confirmed by gas chromatography/mass spectroscopy. Measures analyzed include medical (birth) and developmental (birth, 1 month, 6 months) assessments, all performed by blinded evaluators, as well as caregiver characteristics and environmental factors (birth, 1 month). A series of four theoretical models was tested, one for each time point (birth, 1 month, 6 months) and a longitudinal model spanning birth to 6 months. Key findings include direct effects of prenatal cocaine exposure on development at birth in the birth model and on development at birth and 6 months in the longitudinal model. In addition, indirect effects of prenatal cocaine exposure were identified on development at birth, 1 month, and 6 months, mediated through the prenatal use of alcohol and tobacco and the birth head circumference. Implications of these and other findings, including the advantages and limitations of structural equation modeling, are discussed.
Marylou Behnke; Fonda Davis Eyler; Cynthia Wilson Garvan; Kathleen Wobie; Weir Hou
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurotoxicology and teratology     Volume:  24     ISSN:  0892-0362     ISO Abbreviation:  Neurotoxicol Teratol     Publication Date:    2002 May-Jun
Date Detail:
Created Date:  2002-05-15     Completed Date:  2002-12-19     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  8709538     Medline TA:  Neurotoxicol Teratol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  283-95     Citation Subset:  IM    
Department of Pediatrics, College of Medicine, University of Florida, Box 100296, Gainesville, FL 32610, USA.
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MeSH Terms
Child Development / drug effects*
Cocaine-Related Disorders / complications,  physiopathology*,  urine
Crack Cocaine / adverse effects*,  urine
Head / growth & development
Infant, Newborn
Longitudinal Studies
Pregnancy Complications / physiopathology*
Prenatal Exposure Delayed Effects*
Prospective Studies
Reg. No./Substance:
0/Crack Cocaine

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