Essay: Analysing study – effects of prenatal cocaine exposure on child behavior and growth at 10 years of age

It is hard to stop one from a drug addiction, but it is even harder for them to stop themselves. Some do not see how harmful, for them and for the people around them, is to be addicted to a specific drug, for example cocaine. Drugs are risky for everybody, but especially for women who are pregnant and for the newborn. Babies born to moms who use drugs during pregnancy of then have complications, like premature birth, low birth weight, heart defects, birth defects, infections. Also, most children born with cocaine addicted mothers are born addicted themselves. The article, “Effects of prenatal cocaine exposure on child behavior and growth at 10 years of age”, presents a research study on how the prenatal use of cocaine affects child development. The goal of it is to provide enough information about the effects on prenatal cocaine exposure on child development in order to make women more aware of the issue in order to make the right decision. Moreover, comparing to non-exposed offspring, offspring exposed to prenatally use of cocaine had more problems with regulating their behavior at 1 year and with externalization. They were disobeying rules, threatening and physically aggravating others. Also, they had problems with internalizing behaviors at 3 and 7 years. However, according to the article, other factors like maternal depression, socioeconomic status, home environment and parenting characteristics can affect a child development.
One of the hypothesis of the study is that prenatal use of cocaine affects the behavior is middle childhood, as the brain develops, while taking in consideration other factors that are associated with child behavior problems. Also, another one of the hypothesis of the study is that prenatal use of cocaine also affects growth at 10 years.
In order to do the research study and make sure all the information is accurate, the researchers needed to come up with a method of how to choose their participants and the procedures. For the study women 18 years or older who attended the prenatal clinic at Magee-Womens Hospital (MWH) in Pittsburg, PA from March 1988 to December 1992 were eligible to participate. A written consent and a Certificate of Confidentially was obtained to assure the participants that their responses could not be shown or used somewhere else. Moreover, women were approached for the interview during their fourth and fifth prenatal month, and also no information about the drug use was taken from the participants before they participated in the study. Some women refused to participate, however the researchers took a random sample from them to see if their disapproval had something to do with drug us, but only 5% had a history of drug use during pregnancy. Women were interviewed about their drug use for the year before pregnancy and for the first trimester. Women selected for the study were interviewed at seven months about their drug use during their second trimester and then again at 24 to 48h postpartum-data were collected on all of the variables in the data set. Then, the mothers and infants were assessed at 1,3,7 and 10 years postpartum. At all phases women were asked about their substance use over the past year, sociodemographic characteristics, life events, social support, household composition, and psychiatric symptoms, all data was collected.
Over the research study many women become ineligible to participate because of abortion/miscarriage/infant death/home delivery or moving out of area. Of the remaining 303 eligible women, 1 was lost to follow-up and 2 refused further participation. So, delivery assessments were completed on 300 mothers. The variables of the study were maternal cocaine and crack, tabacco, alcohol, marijuana, and other drugs. Cocaine and crack use were reported in lines, rocks, or grams. Alcohol and marijuana variables were average number of drinks or joints per dat. Tabacco use was analyzes as number of cigarettes per day. At 10 years, the child’s height, weight, and head circumference were measure by child assessment staff who were blind to prenatal drug use, and also the mothers rated the child in terms of emotionally distress, degree of activity.
As the researchers came closer to the end of the study they separated the results portion in three parts, descriptive analyses, regression analyses, and mediating analyses. In the descriptive analyses part, they observed that during the first, second and third trimesters, 42.4%, 7.5%, and 10.3% of the women used cocaine. Cocaine use increased during the early postpartum years (14.9% and 12.9% at 1 and 3 years), but decreased to 8.6% and 9.7% at 7 and 10 years. All the women enrolled in the study who used cocaine during the first trimester were more likely to be African-American, older, had lower family incomes, and were more likely to be single comparing to the non-users during the first trimester. Their use of cocaine could have resulted from family distress, stress, environment, peer pressure. Regression analyses consist in first trimester cocaine use which was a significant predictor of reduced weight, height, and head circumference at 10 years of age. The children’s mother and care givers reported them less sociable, depresses, anxious by the first trimester of cocaine use. Mediating analyses show how exposure to violence mediated the effect of first trimester.
Overall, in the 10-year follow-up of a prospective, longitudinal study, the researchers look over whether prenatal cocaine exposure was related to grow and behavior. Prenatal cocaine exposure had a long-lasting effect on growth, since both 10-year weight and height were affected by first trimester use. Maternal depression was also a predictor of child depression. A contribution of this report is that the researchers investigated the mediating effect of exposure to violence. Childhood exposure to violence was correlated with prenatal use of cocaine and with the behavior, however it maybe not have an effect on temperament, since temperament is a stable characteristic across development. Moreover, prenatal use of cocaine affects brain function and behavior. The strengths of this study include the researcher’s assessment of the spectrum of exposure and the timing of PCE on development. Other studies talk about cocaine use across pregnancy and do not evaluate the timing of exposure. This study talks about the patterns of substance use in general population of pregnant women and lets the researchers study the effect on prenatal cocaine exposure. Another strength would be that the study includes the prospective design, good follow-up rates, and statistical control for confounding factors, including other drugs and environment conditions. One of the limitations of the study is that the researchers did not have biological measures of prenatal drug use and it could have led to misclassification of women who denied use.
Source:
Effects of prenatal cocaine exposure on child behavior and growth at 10 years of age
Gale A Richardson 1, Lidush Goldschmidt, Cynthia Larkby, Nancy L Day