Fetal cocaine exposure tied to behavior problems

NEW YORK (Reuters Health) - Children exposed to cocaine in the womb exhibit behavior problems up to at least 7 years of age, according to a long-term study that enrolled 1,388 children between 1993 and 1995 at four centers.

Children exposed to cocaine in the womb were matched with a group of nonexposed children. At ages 3, 5, and 7 years, a total of 1,056 children were assessed for behavior problems using the Child Behavior Checklist.

After controlling for possibly confounding factors, Dr. Henrietta S. Bada, of the University of Kentucky College of Medicine, Lexington and colleagues found an association between high levels of prenatal cocaine exposure and behavior problems including internalizing and externalizing behaviors.

Prenatal and postnatal exposure to tobacco and alcohol were also significantly associated with behavior problems through age 7 years. Having a parent or other caregiver with a history of depression and physical or sexual abuse was independently associated with all behavior problems.

"Our findings highlight not only a need for continued prevention and treatment programs that are directed toward illegal drug use but also a call for increased effort toward prevention of tobacco and alcohol use, which is a more prevalent problem and has as great an impact on childhood behavior problems as prenatal cocaine exposure," the authors write.

"Furthermore," they say, "in the evaluation of a child with behavior problems, in addition to information on prenatal and postnatal drug exposures, the possible influences on behavior of caregiver mental health and adverse factors in the home or environment must be examined because these risks add to the effects of drug exposures."

SOURCE: Pediatrics February 2007.