The Effects of Prenatal Cocaine Exposure in Adolescence

Sonia Minnes, Lynn Singer, Meeyoung O. Min, Miaoping Wu, Adelaide Lang, Susan Yoon

First Published: 1 January 2014 DIO:  10.1016/j.drugalcdep.2013.09.031

Case Western University

Abstract

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This is a continuation of grant RO1 DA07957, “The Effects of Prenatal Cocaine Exposure at School Age,” a longitudinal study of the prenatal effects of cocaine/polydrug exposure (n=382; 194 cocaine-exposed and 188 non-cocaine-exposed). This study, as well as others, have found differences among prenatally cocaine-exposed children that include deficits in perceptual reasoning, attention, language development, and externalizing behavior problems compared to non-exposed children. The effects of environmental lead exposure and the differential impact of caregiver placement have been identified as important determinants of early developmental outcomes in this cohort, indicating the need for continued study at this developmental stage of newly emerging risk behaviors and social stress. We propose following this large cohort from age 15 through 18 years with the overarching objective of determining whether the negative effects of prenatal cocaine exposure on brain development continue to interfere with optimal developmental outcomes and if cocaine exposure is associated with increased incidence of risky behavior, particularly substance misuse and mental health problems.

Adolescents will be assessed using self and caregiver reports, interviews, bioassays, and standardized assessments. Specific aims are to assess the relationship of prenatal cocaine exposure to cognitive and behavioral outcomes (risk-taking and mental health problems) in adolescence and to assess lead levels, iron deficiency, caregiving, and environmental correlates of exposure; explore models that assess the relationship of early cognitive deficits and behavior problems to risk-taking behaviors in an adolescent high-risk cocaine/polydrug exposed cohort; assess parenting experiences and behaviors of caregivers of cocaine-exposed and non-exposed adolescents; and assess the direct and indirect relationships of prenatal cocaine exposure to adolescent behavioral outcomes. Our model focuses on the mediating effects of earlier deficits in cognitive performance, attention, and inhibitory control on risk-taking behavior and the moderating effects of gender. Effects of lead exposure, iron deficiency, and caregiving environment will be explored using structural equation modeling (SEM) and path modeling. The results of this study will provide the basis for designing culturally sensitive interventions prenatally or early in life that could reduce risky teen behaviors and ultimately reduce serious lifelong health problems, including substance dependence, trauma, and HIV infection.

Keywords: prenatal cocaine exposure, adolescence, growth, behavior problems, delinquency

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