PEDIATRICS Vol. 92 No. 3 September 1993, pp. 396-402
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Outcome of Children Prenatally Exposed to Cocaine and Other Drugs: A Path Analysis of Three-Year Data

Scott D. Azuma PhD1 and Ira J. Chasnoff MD1

1 From the National Association for Perinatal Addiction Research and Education (NAPARE), Chicago, IL.

Objective. Cocaine and other drug use during pregnancy continues to be a major health concern. With increasing use of cocaine by women of childbearing age, large numbers of children have been exposed to this and other substances in utero. Currently, very little information regarding the long-term developmental implications of cocaine/polydrug exposure exists. The purpose of this study is to present 3-year cognitive and behavioral data on infants exposed to cocaine and other drugs during gestation.

Methods. The subjects and controls in this study are currently enrolled in a longitudinal, prospective evaluation. At 3 years of age, 92 children exposed to cocaine and other drugs, 25 children exposed to multiple drugs but no cocaine, and 45 drug-free controls were evaluated using the Stanford-Binet Intelligence Scale (fourth edition), the Child Behavioral Checklist, the Home Screening Questionnaire, and a Summative Perseverance Scale. The data were analyzed using an a priori model and path analytic procedures.

Results. The results indicate that prenatal drug exposure has significant direct and indirect effects on 3-year cognitive functioning as measured on the Stanford-Binet scale. The fit indices indicated that overall, the hypothesized model accurately reflected the actual data.

Conclusions. The findings of the study provide specific evidence elucidating the nature of long-term developmental risk associated with intrauterine drug exposure. Drug exposure was found to have a direct effect on cognitive ability at 3 years of age. However, the effects of drug exposure are also mediated indirectly through head circumference, home environment, and level of perseverance at a task. Future explorations should continue to utilize path analysis techniques to further clarify the ramifications of drug exposure on the development of the growing child.

Key Words: cocaine • drugs • child development

Submitted on November 4, 1992
Accepted on March 25, 1993




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