Growth, development, and behavior in early childhood following prenatal cocaine exposure: a systematic review
by
Frank DA, Augustyn M, Knight WG, Pell T, Zuckerman B.
Boston University School of Medicine,
Boston, MA 02118-2393, USA.
[email protected]
JAMA 2001 Mar 28; 285(12):1613-25
ABSTRACTCONTEXT: Despite recent studies that failed to show catastrophic effects of prenatal cocaine exposure, popular attitudes and public policies still reflect the belief that cocaine is a uniquely dangerous teratogen. OBJECTIVE: To critically review outcomes in early childhood after prenatal cocaine exposure in 5 domains: physical growth; cognition; language skills; motor skills; and behavior, attention, affect, and neurophysiology. DATA SOURCES: Search of MEDLINE and Psychological Abstracts from 1984 to October 2000. STUDY SELECTION: Studies selected for detailed review (1) were published in a peer-reviewed English-language journal; (2) included a comparison group; (3) recruited samples prospectively in the perinatal period; (4) used masked assessment; and (5) did not include a substantial proportion of subjects exposed in utero to opiates, amphetamines, phencyclidine, or maternal human immunodeficiency virus infection. DATA EXTRACTION: Thirty-six of 74 articles met criteria and were reviewed by 3 authors. Disagreements were resolved by consensus. DATA SYNTHESIS: After controlling for confounders, there was no consistent negative association between prenatal cocaine exposure and physical growth, developmental test scores, or receptive or expressive language. Less optimal motor scores have been found up to age 7 months but not thereafter, and may reflect heavy tobacco exposure. No independent cocaine effects have been shown on standardized parent and teacher reports of child behavior scored by accepted criteria. Experimental paradigms and novel statistical manipulations of standard instruments suggest an association between prenatal cocaine exposure and decreased attentiveness and emotional expressivity, as well as differences on neurophysiologic and attentional/affective findings. CONCLUSIONS: Among children aged 6 years or younger, there is no convincing evidence that prenatal cocaine exposure is associated with developmental toxic effects that are different in severity, scope, or kind from the sequelae of multiple other risk factors. Many findings once thought to be specific effects of in utero cocaine exposure are correlated with other factors, including prenatal exposure to tobacco, marijuana, or alcohol, and the quality of the child's environment. Further replication is required of preliminary neurologic findings.Sperm
Oocytes
Crack babies
Foetal cocaine
Crack and crime
Prenatal cocaine
Dopaminergic flies?
Dopaminergic agents
Cocaine immunization
The coke-craving brain
Cocaine and the lonely rat
Freebasing flies go hyperkinetic
01 02 03 04 05 06 07 08 09 10 11 12
13 14 15 16 17 18 19 20 21 22 23 24
MORE
HedWeb
cannabis-marijuana.com
Future Opioids
BLTC Research
Wirehead Hedonism
Paradise-Engineering
Utopian Pharmacology
The Hedonistic Imperative
When Is It Best to Take Crack Cocaine?
The Good Drug Guide
The Responsible Parent's Guide To
Healthy Mood Boosters For All The Family
