Estimated effect of prenatal cocaine exposure on examiner-rated behavior at age 7 years |
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Authors: | Accornero Veronica H Anthony James C Morrow Connie E Xue Lihua Mansoor Elana Johnson Arnise L McCoy Clyde B Bandstra Emmalee S |
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Institution: | a University of Miami Miller School of Medicine, Department of Pediatrics, P.O. Box 016960 (M-808), Miami, FL 33101, United Statesb Michigan State University, Department of Epidemiology, B601 West Fee Hall, East Lansing, MI 48824, United Statesc Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, 1120 NW 14th Street, Room 906, Miami, FL 33136, United Statesd University of Miami Miller School of Medicine, Department of Pediatrics, Division of Neonatology, P.O. Box 016960 (R-131), Miami, FL 33101, United States |
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Abstract: | Prenatal cocaine exposure has been linked to increased child behavior difficulties in some studies but not others.ObjectiveThe primary aim was to estimate the relationship between in utero cocaine exposure and child behavioral functioning at age 7 years with ratings made by blinded examiners during a structured testing session. A second aim was to examine whether caregiver drug use and psychological problems might mediate suspected relationships between prenatal cocaine exposure and aspects of examiner-rated behavior.Methods407 children (212 cocaine-exposed, 195 non-exposed) participating in the longitudinal Miami Prenatal Cocaine Study (MPCS) were rated with regard to their behavior during a neuropsychological assessment conducted at age 7 years. Raters were trained research psychometricians blinded to drug exposure status. Individual behavioral items were summarized and the cocaine-behavior relationship was estimated within the context of latent variable modeling, using Mplus software.ResultsTwo latent variables, Behavioral Regulation and Sociability, were derived via exploratory latent structure analysis with promax rotation. Prenatal cocaine exposure, statistically controlling for child sex, test age, and prenatal exposure to alcohol, tobacco, and marijuana, was associated with Behavioral Regulation (estimated slope ß = − 0.25; 95% CI = − 0.48, − 0.02; p = 0.04) but not Sociability (estimated slope ß = − 0.03; 95% CI = − 0.26, 0.20; p = 0.79). Neither postnatal drug use by caregivers nor the severity of their psychological problems at age 5 follow-up predicted levels of child Behavioral Regulation or Sociability at age 7 years (p > 0.10).ConclusionsExaminer ratings of child behavior at age 7 revealed less optimal behavioral regulation for prenatally cocaine-exposed compared to non-exposed children, in contrast with what had been previously found from parent-report data. This evidence highlights the potential value of trained observers in assessing behavioral outcomes of children exposed in utero to drugs and other toxicants. |
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Keywords: | Prenatal cocaine exposure Behavior Examiner ratings Caregiver drug use Caregiver psychological functioning Behavioral regulation |
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