Cognitive and motor outcomes of cocaine-exposed infants.
BACKGROUND
Maternal use of cocaine during pregnancy remains a significant public health problem, particularly in urban areas of the United States and among women of low socioeconomic status. Few longitudinal studies have examined cocaine-exposed infants, however, and findings are contradictory because of methodologic limitations.


OBJECTIVE
To assess the effects of prenatal cocaine exposure on child developmental outcomes.


METHODS
Longitudinal, prospective, masked, comparison birth cohort study with recruitment in 1994-1996.


METHODS
Obstetric unit of a large US urban teaching hospital.


METHODS
Four hundred fifteen consecutively enrolled infants (218 cocaine-exposed and 197 unexposed) identified from a high-risk, low-socioeconomic status, primarily black (80%) population screened through clinical interview and urine and meconium samples for drug use. The retention rate was 94% at 2 years of age.


METHODS
The Bayley Mental and Motor Scales of Infant Development, assessed at 6.5, 12, and 24 months of corrected age.


RESULTS
Controlled for confounding variables, cocaine exposure had significant effects on cognitive development, accounting for a 6-point deficit in Bayley Mental and Motor Scales of Infant Development scores at 2 years, with cocaine-exposed children twice as likely to have significant delay (mental development index <80) (odds ratio, 1.98; 95% confidence interval, 1.21-3.24; P =.006). For motor outcomes, there were no significant cocaine effects.


CONCLUSIONS
Cocaine-exposed children had significant cognitive deficits and a doubling of the rate of developmental delay during the first 2 years of life. Because 2-year outcomes are predictive of later cognitive outcomes, it is possible that these children will continue to have learning difficulties at school age.
Singer
Lynn T
LT
Department of Pediatrics, Case Western Reserve University, Triangle Bldg, 11400 Euclid Ave, Suite 250-A, Cleveland, OH 44106, USA. lxs5@po.cwru.edu
Arendt
Robert
R
Minnes
Sonia
S
Farkas
Kathleen
K
Salvator
Ann
A
Kirchner
H Lester
HL
Kliegman
Robert
R
D001034:Apgar Score; D001724:Birth Weight; D019970:Cocaine-Related Disorders / Q000150:complications*; D003071:Cognition; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008470:Meconium / Q000737:chemistry; D009483:Neuropsychological Tests; D011247:Pregnancy; D011248:Pregnancy Complications; D011297:Prenatal Exposure Delayed Effects; D011597:Psychomotor Performance; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric