title: The effect of prenatal methamphetamine exposure on attention as assessed by continuous performance tests: results from the Infant Development, Environment, and Lifestyle study.
abstract: OBJECTIVE
  To assess for the increased risk of attention-deficit hyperactivity disorder (ADHD) in young children with prenatal methamphetamine exposure from the multicenter, longitudinal Infant Development, Environment, and Lifestyle (IDEAL) study.
  
  
  METHODS
  The IDEAL study enrolled 412 mother-infant pairs at 4 sites (Tulsa, OK; Des Moines, IA; Los Angeles, CA; and Honolulu, HI). Methamphetamine-exposed subjects (n = 204) were identified by self-report and/or gas chromatography/mass spectrometry confirmation of amphetamine and metabolites in infant meconium. Matched subjects (n = 208) denied methamphetamine use and had a negative meconium screen. This analysis included a subsample of 301 subjects who were administered the Conners' Kiddie Continuous Performance Test (K-CPT) at 5.5 years of age (153 exposed and 148 comparison). Hierarchical linear models adjusted for covariates tested exposure effects on K-CPT measures. Using the same covariates, logistic regression was used to determine the effect of exposure on the incidence of a positive ADHD confidence index score, defined as greater than 50%.
  
  
  RESULTS
  There were no differences between the groups in omission or commission errors or reaction time for correct trials. However, methamphetamine exposure was associated with subtle differences in other outcomes predictive of ADHD, including increased slope of reaction time across blocks (p < .001), increased variability in reaction time with longer interstimulus intervals (p < .01), and increased likelihood of greater than 50% on the ADHD confidence index (odds ratio, 3.1; 95% confidence interval, 1.2-7.8; p = .02).
  
  
  CONCLUSIONS
  Prenatal methamphetamine exposure was associated with subtle differences in K-CPT scores at 5.5 years of age. Even at this relatively young age, these children exhibit indicators of risk for ADHD and warrant monitoring.
authors.affiliation: LA BioMed Institute, Harbor-UCLA Medical Center, David Geffen School of Medicine, Los Angeles, CA 90502, USA.
authors.forename: Zeina N
authors.initials: ZN
authors.lastname: Kiblawi
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Smith
authors.forename: Linda L
authors.initials: LL
authors.lastname: LaGasse
authors.forename: Chris
authors.initials: C
authors.lastname: Derauf
authors.forename: Elana
authors.initials: E
authors.lastname: Newman
authors.forename: Rizwan
authors.initials: R
authors.lastname: Shah
authors.forename: Amelia
authors.initials: A
authors.lastname: Arria
authors.forename: Marilyn
authors.initials: M
authors.lastname: Huestis
authors.forename: Sheri
authors.initials: S
authors.lastname: DellaGrotta
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Dansereau
authors.forename: Charles
authors.initials: C
authors.lastname: Neal
authors.forename: Barry
authors.initials: B
authors.lastname: Lester
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000150:complications; D001288:Attention / Q000187:drug effects*; D001289:Attention Deficit Disorder with Hyperactivity / Q000139:chemically induced; D016022:Case-Control Studies; D000697:Central Nervous System Stimulants / Q000009:adverse effects* / Q000032:analysis; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008470:Meconium / Q000737:chemistry; D008694:Methamphetamine / Q000009:adverse effects* / Q000032:analysis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology; D011297:Prenatal Exposure Delayed Effects / Q000209:etiology / Q000523:psychology*; D011581:Psychological Tests
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine