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Neurodevelopment of adopted children exposed in utero to cocaine.
CMAJ. 1994 Dec 01; 151(11):1591-7.CMAJ

Abstract

OBJECTIVE

To assess the neurodevelopment of adopted children who had been exposed in utero to cocaine.

DESIGN

A case-control observational study.

PARTICIPANTS

Twenty-three children aged 14 months to 6.5 years exposed in utero to cocaine and their adoptive mothers, and 23 age-matched control children not exposed to cocaine and their mothers, matched with the adoptive mothers for IQ and socioeconomic status.

SETTING

The Motherisk Programme at The Hospital for Sick Children, Toronto, a consultation service for chemical exposure during pregnancy.

MAIN OUTCOME MEASURES

Height, weight and head circumference at birth and at follow-up, and achievement on standard tests of cognitive and language development.

RESULTS

Compared with the control group, children exposed in utero to cocaine had an 8-fold increased risk for microcephaly (95% confidence interval 1.5 to 42.3); they also had a lower mean birth weight (p = 0.005) and a lower gestational age (p = 0.002). In follow-up the cocaine-exposed children caught up with the control subjects in weight and stature but not in head circumference (mean 31st percentile v. 63rd percentile) (p = 0.001). Although there were no significant differences between the two groups in global IQ, the cocaine-exposed children had significantly lower scores than the control subjects on the Reynell language test for both verbal comprehension (p = 0.003) and expressive language (p = 0.001).

CONCLUSIONS

This is the first study to document that intrauterine exposure to cocaine is associated with measurable and clinically significant toxic neurologic effects, independent of postnatal home and environmental confounders. Because women who use cocaine during pregnancy almost invariably smoke cigarettes and often use alcohol, it is impossible to attribute the measured toxic effects to cocaine alone.

Authors+Show Affiliations

Department of Paediatrics, University of Toronto, Ont.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

7954158

Citation

Nulman, I, et al. "Neurodevelopment of Adopted Children Exposed in Utero to Cocaine." CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, vol. 151, no. 11, 1994, pp. 1591-7.
Nulman I, Rovet J, Altmann D, et al. Neurodevelopment of adopted children exposed in utero to cocaine. CMAJ. 1994;151(11):1591-7.
Nulman, I., Rovet, J., Altmann, D., Bradley, C., Einarson, T., & Koren, G. (1994). Neurodevelopment of adopted children exposed in utero to cocaine. CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, 151(11), 1591-7.
Nulman I, et al. Neurodevelopment of Adopted Children Exposed in Utero to Cocaine. CMAJ. 1994 Dec 1;151(11):1591-7. PubMed PMID: 7954158.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neurodevelopment of adopted children exposed in utero to cocaine. AU - Nulman,I, AU - Rovet,J, AU - Altmann,D, AU - Bradley,C, AU - Einarson,T, AU - Koren,G, PY - 1994/12/1/pubmed PY - 1994/12/1/medline PY - 1994/12/1/entrez SP - 1591 EP - 7 JF - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne JO - CMAJ VL - 151 IS - 11 N2 - OBJECTIVE: To assess the neurodevelopment of adopted children who had been exposed in utero to cocaine. DESIGN: A case-control observational study. PARTICIPANTS: Twenty-three children aged 14 months to 6.5 years exposed in utero to cocaine and their adoptive mothers, and 23 age-matched control children not exposed to cocaine and their mothers, matched with the adoptive mothers for IQ and socioeconomic status. SETTING: The Motherisk Programme at The Hospital for Sick Children, Toronto, a consultation service for chemical exposure during pregnancy. MAIN OUTCOME MEASURES: Height, weight and head circumference at birth and at follow-up, and achievement on standard tests of cognitive and language development. RESULTS: Compared with the control group, children exposed in utero to cocaine had an 8-fold increased risk for microcephaly (95% confidence interval 1.5 to 42.3); they also had a lower mean birth weight (p = 0.005) and a lower gestational age (p = 0.002). In follow-up the cocaine-exposed children caught up with the control subjects in weight and stature but not in head circumference (mean 31st percentile v. 63rd percentile) (p = 0.001). Although there were no significant differences between the two groups in global IQ, the cocaine-exposed children had significantly lower scores than the control subjects on the Reynell language test for both verbal comprehension (p = 0.003) and expressive language (p = 0.001). CONCLUSIONS: This is the first study to document that intrauterine exposure to cocaine is associated with measurable and clinically significant toxic neurologic effects, independent of postnatal home and environmental confounders. Because women who use cocaine during pregnancy almost invariably smoke cigarettes and often use alcohol, it is impossible to attribute the measured toxic effects to cocaine alone. SN - 0820-3946 UR - https://www.unboundmedicine.com/medline/citation/7954158/Neurodevelopment_of_adopted_children_exposed_in_utero_to_cocaine_ L2 - http://www.cmaj.ca/cgi/pmidlookup?view=reprint&pmid=7954158 DB - PRIME DP - Unbound Medicine ER -