Neurodevelopment of adopted children exposed in utero to cocaine.
OBJECTIVE
To assess the neurodevelopment of adopted children who had been exposed in utero to cocaine.


METHODS
A case-control observational study.


METHODS
Twenty-three children aged 14 months to 6.5 years exposed in utero to cocaine and their adoptive mothers, and 23 age-matched control children not exposed to cocaine and their mothers, matched with the adoptive mothers for IQ and socioeconomic status.


METHODS
The Motherisk Programme at The Hospital for Sick Children, Toronto, a consultation service for chemical exposure during pregnancy.


METHODS
Height, weight and head circumference at birth and at follow-up, and achievement on standard tests of cognitive and language development.


RESULTS
Compared with the control group, children exposed in utero to cocaine had an 8-fold increased risk for microcephaly (95% confidence interval 1.5 to 42.3); they also had a lower mean birth weight (p = 0.005) and a lower gestational age (p = 0.002). In follow-up the cocaine-exposed children caught up with the control subjects in weight and stature but not in head circumference (mean 31st percentile v. 63rd percentile) (p = 0.001). Although there were no significant differences between the two groups in global IQ, the cocaine-exposed children had significantly lower scores than the control subjects on the Reynell language test for both verbal comprehension (p = 0.003) and expressive language (p = 0.001).


CONCLUSIONS
This is the first study to document that intrauterine exposure to cocaine is associated with measurable and clinically significant toxic neurologic effects, independent of postnatal home and environmental confounders. Because women who use cocaine during pregnancy almost invariably smoke cigarettes and often use alcohol, it is impossible to attribute the measured toxic effects to cocaine alone.
Department of Paediatrics, University of Toronto, Ont.
I
I
Nulman
J
J
Rovet
D
D
Altmann
C
C
Bradley
T
T
Einarson
G
G
Koren
D000300:Adoption; D000704:Analysis of Variance; D001827:Body Height / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D016022:Case-Control Studies; D002508:Cephalometry; D002648:Child; D002675:Child, Preschool; D003042:Cocaine / Q000009:adverse effects*; D003071:Cognition / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D009420:Nervous System / Q000187:drug effects* / Q000254:growth & development*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D013060:Speech / Q000187:drug effects
D003042:Cocaine