Children with and without gestational cocaine exposure: a neurocognitive systems analysis.
BACKGROUND
Concern for effects of gestational cocaine exposure (GCE) on human neurocognitive (NC) development is based on effects of cocaine on blood flow to the fetus and impact of cocaine on developing monoaminergic systems. GCE has been shown to affect language, attention and perceptual reasoning skills.


OBJECTIVE
Our objective was to investigate effects of GCE on 7 NC systems, assessed behaviorally in middle school-aged, low socioeconomic status subjects followed prospectively since birth.


METHODS
55 GCE and 65 non-exposed Control subjects were tested with a battery of 14 tasks adapted from neuroimaging and lesion literature designed to tap 3 frontal systems (Cognitive Control, Working Memory, and Reward Processing) and 4 non-frontal systems (Language, Memory, Spatial Cognition, and Visual Cognition). Using multivariate analysis of covariance, we assessed the relation between NC functioning and GCE status with the following covariates: age at testing; gender; gestational exposure to cigarettes, alcohol and marijuana; foster care placement; caregiver current cocaine use; and two indices of childhood environment.


RESULTS
None of the analyses showed an effect of GCE on NC function. In contrast, child characteristics, including age at testing and childhood environment, were associated with NC function.


CONCLUSIONS
In this cohort there is either no effect of GCE on NC function at middle school age, or that effect is less pronounced than the effect of age or childhood environment.
Hurt
Hallam
H
Division of Neonatology, Department of Pediatrics, University of Pennsylvania and The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. hurt@email.chop.edu
Betancourt
Laura M
LM
Malmud
Elsa K
EK
Shera
David M
DM
Giannetta
Joan M
JM
Brodsky
Nancy L
NL
Farah
Martha J
MJ
D000328:Adult; D002648:Child; D002657:Child Development / Q000187:drug effects; D003042:Cocaine / Q000633:toxicity*; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000523:psychology; D003071:Cognition / Q000187:drug effects*; D005260:Female; D006801:Humans; D007802:Language; D008137:Longitudinal Studies; D008297:Male; D008570:Memory, Short-Term / Q000187:drug effects; D011247:Pregnancy; D011248:Pregnancy Complications; D011297:Prenatal Exposure Delayed Effects / Q000523:psychology*; D012201:Reward
D003042:Cocaine
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