Developmental outcomes and environmental correlates of very low birthweight, cocaine-exposed infants.
Fetal cocaine exposure may have differentially adverse effects on developmental outcomes of very low birthweight (VLBW) infants. As part of a longitudinal study, 31 cocaine-positive very low birthweight infants, and age, race and socioeconomic status matched VLBW controls enrolled at birth were followed. Neonatal maternal-child interactions, concurrent maternal psychological characteristics and environmental factors conceptualized as important for child outcome were assessed as well as standard developmental outcomes at 3 years. In the neonatal period, cocaine-exposed VLBW infants who remained in maternal custody tended to be rated as less responsive and their mothers as less nurturing, less emotionally available and with a tendency to use more maladaptive coping mechanisms than nonexposed VLBW infants. At follow-up, cocaine-exposed VLBW children were delayed in cognitive, motor and language development compared to controls. Almost half (45%) of the exposed children scored in the range of mental retardation compared to 16% of the comparison VLBW children. The persistent cognitive, motor and language delays of the cocaine-exposed VLBW children, combined with the poorer behavioral interactions of cocaine-using women with their infants in the neonatal period, indicate a need for increased developmental surveillance of cocaine-exposed VLBW infants with a focus on maternal drug treatment and parenting interventions.
Singer
L T
LT
Department of Pediatrics, School of Medicine, Case Western Reserve University, Suite 250-A, The Triangle Building, 11400 Euclid Avenue, Cleveland, OH 44106, USA. lxs5@po.cwru.edu
Hawkins
S
S
Huang
J
J
Davillier
M
M
Baley
J
J
D000328:Adult; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000523:psychology; D002658:Developmental Disabilities / Q000139:chemically induced*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008137:Longitudinal Studies; D008297:Male; D008425:Maternal Behavior / Q000187:drug effects* / Q000523:psychology; D018811:Maternal Exposure / Q000009:adverse effects; D008431:Maternal-Fetal Exchange; D009034:Mother-Child Relations; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects