title: School-Aged Outcomes following Prenatal Methamphetamine Exposure: 7.5-Year Follow-Up from the Infant Development, Environment, and Lifestyle Study.
abstract: OBJECTIVE
  To assess the relationship between prenatal methamphetamine exposure (PME) and behavior problems at age 7.5 years and the extent to which early adversity mediated this relationship.
  
  
  METHODS
  The multicenter, longitudinal Infant Development, Environment, and Lifestyle study enrolled 412 mother-infant pairs at 4 sites. Methamphetamine-exposed participants (n = 204) were identified by self-report and/or gas chromatography/mass spectrometry confirmation of amphetamine and metabolites in infant meconium. Matched participants (n = 208) denied methamphetamine use and had a negative meconium screen. At the 7.5-year follow-up, 290 children with complete Child Behavior Checklist data and an early adversity index score were available for analysis (n = 146 exposed).
  
  
  RESULTS
  PME was significantly associated with an increased early adversity index score (P < .001) and with increased externalizing, rule-breaking behavior, and aggressive behavior (P < .05). Early adversity was also associated with higher externalizing behavior scores. Early adversity significantly mediated the relationship between PME and behavioral problems. After adjusting the mediation model for sex, prenatal tobacco, alcohol, and marijuana exposures, and study site, the association of PME with early adversity remained significant.
  
  
  CONCLUSIONS
  Though PME is associated with behavioral problems, early adversity may be a strong determinant of behavioral outcome for children exposed to methamphetamine in utero. Early adversity significantly mediated the relationship between PME and behavioral problems.
authors.affiliation: Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles (UCLA) and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA.
authors.forename: Nwando
authors.initials: N
authors.lastname: Eze
authors.affiliation: Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles (UCLA) and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA. Electronic address: smith@labiomed.org.
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Smith
authors.affiliation: Pediatrics Division, Brown Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI.
authors.forename: Linda L
authors.initials: LL
authors.lastname: LaGasse
authors.affiliation: John A. Burns School of Medicine, University of Hawaii, Honolulu, HI.
authors.forename: Chris
authors.initials: C
authors.lastname: Derauf
authors.affiliation: Department of Psychology, The University of Tulsa, Tulsa, OK.
authors.forename: Elana
authors.initials: E
authors.lastname: Newman
authors.affiliation: Center for Substance Abuse Research, University of Maryland, College Park, MD.
authors.forename: Amelia
authors.initials: A
authors.lastname: Arria
authors.affiliation: Section on Chemistry and Drug Metabolism, National Institute on Drug Abuse, Bethesda, MD.
authors.forename: Marilyn A
authors.initials: MA
authors.lastname: Huestis
authors.affiliation: Pediatrics Division, Brown Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI.
authors.forename: Sheri A
authors.initials: SA
authors.lastname: Della Grotta
authors.affiliation: Pediatrics Division, Brown Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI.
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Dansereau
authors.affiliation: John A. Burns School of Medicine, University of Hawaii, Honolulu, HI.
authors.forename: Charles
authors.initials: C
authors.lastname: Neal
authors.affiliation: Pediatrics Division, Brown Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI.
authors.forename: Barry M
authors.initials: BM
authors.lastname: Lester
mesh_terms: D019969:Amphetamine-Related Disorders / Q000175:diagnosis / Q000209:etiology*; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D002648:Child; D002652:Child Behavior / Q000187:drug effects*; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000139:chemically induced* / Q000175:diagnosis; D004777:Environment; D005260:Female; D005500:Follow-Up Studies; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008694:Methamphetamine / Q000009:adverse effects*; D009035:Mothers; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine