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JAMA. 2002 Apr 17;287(15):1952-60.

Cognitive and motor outcomes of cocaine-exposed infants.

Author information

1
Department of Pediatrics, Case Western Reserve University, Triangle Bldg, 11400 Euclid Ave, Suite 250-A, Cleveland, OH 44106, USA. lxs5@po.cwru.edu

Abstract

CONTEXT:

Maternal use of cocaine during pregnancy remains a significant public health problem, particularly in urban areas of the United States and among women of low socioeconomic status. Few longitudinal studies have examined cocaine-exposed infants, however, and findings are contradictory because of methodologic limitations.

OBJECTIVE:

To assess the effects of prenatal cocaine exposure on child developmental outcomes.

DESIGN:

Longitudinal, prospective, masked, comparison birth cohort study with recruitment in 1994-1996.

SETTING:

Obstetric unit of a large US urban teaching hospital.

PARTICIPANTS:

Four hundred fifteen consecutively enrolled infants (218 cocaine-exposed and 197 unexposed) identified from a high-risk, low-socioeconomic status, primarily black (80%) population screened through clinical interview and urine and meconium samples for drug use. The retention rate was 94% at 2 years of age.

MAIN OUTCOME MEASURES:

The Bayley Mental and Motor Scales of Infant Development, assessed at 6.5, 12, and 24 months of corrected age.

RESULTS:

Controlled for confounding variables, cocaine exposure had significant effects on cognitive development, accounting for a 6-point deficit in Bayley Mental and Motor Scales of Infant Development scores at 2 years, with cocaine-exposed children twice as likely to have significant delay (mental development index <80) (odds ratio, 1.98; 95% confidence interval, 1.21-3.24; P =.006). For motor outcomes, there were no significant cocaine effects.

CONCLUSIONS:

Cocaine-exposed children had significant cognitive deficits and a doubling of the rate of developmental delay during the first 2 years of life. Because 2-year outcomes are predictive of later cognitive outcomes, it is possible that these children will continue to have learning difficulties at school age.

PMID:
11960537
DOI:
10.1001/jama.287.15.1952
[Indexed for MEDLINE]

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