title: Gender and alcohol moderate caregiver reported child behavior after prenatal cocaine.
abstract: OBJECTIVE
  The concurrence of prenatal alcohol exposure with other drug exposure, low socioeconomic status and environmental risk factors may obscure associations, if any, between prenatal cocaine exposure and child outcomes. This study evaluates the effects of prenatal cocaine exposure on child behavior in analyses stratified by gender and prenatal alcohol exposure status.
  
  
  METHODS
  Maternal alcohol, cigarette, and illicit drug use were prospectively assessed by interview during pregnancy and postnatally. Maternal and neonatal urine were tested for drug exposure as clinically indicated. Caregiver report of child behavior was assessed with the Achenbach Child Behavior Checklist (CBCL). Dichotomous cocaine exposure was characterized as no (negative history and biologic markers), and any (positive history and/or biologic markers during pregnancy and/or positive urine screen at delivery from either mother or infant).
  
  
  RESULTS
  Prenatal cocaine exposure was associated with adverse effects on offspring behavior that were moderated by the gender of the offspring as well as prenatal alcohol exposure. For girls without prenatal alcohol exposure, 6.5% of the unique variance in behavior was related to prenatal cocaine exposure. For these girls, the odds of scoring in the abnormal range for Aggression was 17 times control levels (95% confidence limits 1.4 to 203). These findings, though significant, have wide confidence intervals and need to be replicated in larger cohorts and on longitudinal follow-up.
authors.affiliation: Carman and Ann Adams Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, United States. bsood@med.wayne.edu
authors.forename: Beena G
authors.initials: BG
authors.lastname: Sood
authors.forename: Beth
authors.initials: B
authors.lastname: Nordstrom Bailey
authors.forename: Chandice
authors.initials: C
authors.lastname: Covington
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Sokol
authors.forename: Joel
authors.initials: J
authors.lastname: Ager
authors.forename: James
authors.initials: J
authors.lastname: Janisse
authors.forename: John H
authors.initials: JH
authors.lastname: Hannigan
authors.forename: Virginia
authors.initials: V
authors.lastname: Delaney-Black
mesh_terms: D000374:Aggression / Q000187:drug effects / Q000502:physiology; D017028:Caregivers; D002648:Child; D002652:Child Behavior / Q000187:drug effects*; D002653:Child Behavior Disorders / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology; D003042:Cocaine / Q000633:toxicity*; D000431:Ethanol / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D012189:Retrospective Studies; D012727:Sex Characteristics
chemical_list: D000431:Ethanol; D003042:Cocaine