title: Prenatal cocaine exposure and BMI and blood pressure at  9 years of age.
abstract: BACKGROUND
  Prenatal cocaine exposure has been linked to intrauterine growth retardation and poor birth outcomes; little is known about the effects on longer-term medical outcomes, such as overweight status and hypertension in childhood. Our objective was to examine the association between prenatal cocaine exposure and BMI and blood pressure at 9 years of age among children followed prospectively in a multisite longitudinal study evaluating the impact of maternal lifestyle during pregnancy on childhood outcome.
  
  
  METHODS
  This analysis includes 880 children (277 cocaine exposed and 603 with no cocaine exposure) with blood pressure, height, and weight measurements at 9 years of age. Regression analyses were conducted to explore the relationship between prenatal cocaine exposure and BMI and blood pressure at 9 years of age after controlling for demographics, other drug exposure, birthweight, maternal weight, infant postnatal weight gain, and childhood television viewing, exercise, and dietary habits at 9 years. Path analyses were used to further explore these relationships.
  
  
  RESULTS
  At 9 years of age, 15% of the children were prehypertensive and 19% were hypertensive; 16% were at risk for overweight status and 21% were overweight. A small percentage of women were exposed to high levels of prenatal cocaine throughout pregnancy. A higher BMI was noted in children born to these women. Path analysis suggested that high cocaine exposure has an indirect effect on systolic and diastolic blood pressures that is mediated through its effect on BMI.
  
  
  CONCLUSIONS
  High levels of in-utero cocaine exposure are a marker for elevated BMI and blood pressure among children born full term.
authors.affiliation: Wayne State University School of Medicine, Detroit, Michigan, USA. sshankar@med.wayne.edu
authors.forename: Seetha
authors.initials: S
authors.lastname: Shankaran
authors.forename: Carla M
authors.initials: CM
authors.lastname: Bann
authors.forename: Charles R
authors.initials: CR
authors.lastname: Bauer
authors.forename: Barry M
authors.initials: BM
authors.lastname: Lester
authors.forename: Henrietta S
authors.initials: HS
authors.lastname: Bada
authors.forename: Abhik
authors.initials: A
authors.lastname: Das
authors.forename: Rosemary D
authors.initials: RD
authors.lastname: Higgins
authors.forename: W Kenneth
authors.initials: WK
authors.lastname: Poole
authors.forename: Linda L
authors.initials: LL
authors.lastname: LaGasse
authors.forename: Jane
authors.initials: J
authors.lastname: Hammond
authors.forename: Eunice
authors.initials: E
authors.lastname: Woldt
mesh_terms: D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D003042:Cocaine / Q000008:administration & dosage*; D002149:Energy Intake; D015444:Exercise; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects
chemical_list: D003042:Cocaine