RELATIONSHIP OF PRENATAL COCAINE EXPOSURE AND MATERNAL POSTPARTUM PSYCHOLOGICAL DISTRESS TO CHILD DEVELOPMENTAL OUTCOME

Maternal cocaine use during pregnancy can affect the infant directly t hrough toxic effects or indirectly through cocaine's influence on mate rnal psychological status. Wt followed 160 cocaine exposed and 56 none xposed infants and their mothers identified at birth through interview and/or urine screen. Although cocaine exposure defined the groups, in fant exposure to alcohol, marijuana, and tobacco was allowed to vary. Infants were 99% African American and poor. All mothers completed the Brief Symptom Inventory (ESI) and infants were given the Bayley Scales of Mental (MDI) and Motor (PDI) Development at a mean corrected age o f 17 +/- 8 months. Both MDIs (94 +/- 17 vs. 103 +/- 16) and PDIs (101 +/- 16 vs. 108 +/- 12) were lower for cocaine exposed infants. Psychol ogical distress was greater in cocaine using mothers. Hierarchical mul tiple regression was used to assess the relative effects of gestationa l age, maternal psychological distress, and cocaine and polydrug expos ure on infant outcomes. Both psychological distress and cocaine and al cohol exposure predicted lower MDIs after controlling for prematurity. Neither psychological distress nor alcohol exposure predicted motor o utcome, while cocaine had a significant effect. Tobacco and marijuana exposure were unrelated to outcome. These findings provide further sup port for direct effects of cocaine and alcohol on infant development, as well as highlight the need for studies to document maternal psychol ogical factors, which may increase child risk for poorer outcomes.