Prenatal cocaine use and maternal depression: effects on infant neurobehavior.
OBJECTIVE
The present study examined the impact of both perinatal maternal depression and cocaine use on infant neurobehavior at 1 month of age in a large, multi-site study.


METHODS
Infant neurobehavior was examined in 1053 infants at 1 month of age using the NICU Network Neurobehavioral Scale (NNNS). Mothers were interviewed using The Addiction Severity Index to determine present and past psychiatric history. Four groups were derived from the total sample: 385 prenatally cocaine-exposed infants, 76 whose mothers reported current postpartum depression (DEP/COC) and 309 without current postpartum depression (nonDEP/COC); 668 infants were not exposed to cocaine, 104 whose mothers reported current postpartum depression (DEP/nonCOC), 564 without current postpartum depression (nonDEP/nonCOC). A 2x2 Analysis of Covariance was used with covariates (birthweight, maternal age, SES, nicotine, alcohol, and research site) to examine infant neurobehavior in these four conditions. Secondary analyses were conducted to examine the effects of amount and timing of prenatal cocaine exposure.


RESULTS
DEP group by COC exposure status interactions were significant; there was only a DEP effect in the nonCOC infants. Infants in the nonCOC/DEP group had poorer self-regulation and more stress signs, excitability, and arousal than infants in the other groups.


CONCLUSIONS
Postpartum maternal depression has negative effects on infant neurobehavior at 1 month of age. Prenatal cocaine exposure may serve to suppress or buffer the effects of postpartum depression on infant neurobehavior. Maternal mood could explain some of the inconsistencies found in the prenatal cocaine exposure literature.
Salisbury
Amy L
AL
Brown Medical School, Providence, RI, USA. Amy_Salisbury@brown.edu
Lester
Barry M
BM
Seifer
Ronald
R
Lagasse
Linda
L
Bauer
Charles R
CR
Shankaran
Seetha
S
Bada
Henrietta
H
Wright
Linda
L
Liu
Jing
J
Poole
Ken
K
D000328:Adult; D001143:Arousal / Q000502:physiology; D001288:Attention / Q000502:physiology; D003042:Cocaine / Q000032:analysis / Q000633:toxicity*; D003863:Depression / Q000150:complications*; D019052:Depression, Postpartum / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D018730:Infant Behavior / Q000187:drug effects* / Q000502:physiology*; D007231:Infant, Newborn; D008385:Marijuana Smoking / Q000523:psychology; D009043:Motor Activity / Q000187:drug effects; D009068:Movement / Q000502:physiology; D009357:Neonatal Abstinence Syndrome / Q000523:psychology; D009483:Neuropsychological Tests; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012018:Reflex / Q000187:drug effects; D012907:Smoking / Q000523:psychology; D013315:Stress, Psychological / Q000523:psychology; D019966:Substance-Related Disorders / Q000150:complications; D011795:Surveys and Questionnaires
D003042:Cocaine