COCAINE-EXPOSED PRETERM NEONATES SHOW BEHAVIORAL AND HORMONAL DIFFERENCES

Objective. Prematurity has been associated with prenatal cocaine expos ure, but most studies on the behavioral effects of prenatal cocaine ex posure have been restricted to full-term infant samples. The current s tudy focused on behavioral and hormonal responses in preterm cocaine-e xposed infants compared with a cohort of non-cocaine-exposed infants o f similar gestational age. Methodology. A comparison between 30 cocain e-exposed and 30 non-cocaine-exposed preterm neonates suggested that t he cocaine-exposed neonates were born to mothers who had higher parity and more obstetric complications. In addition, mothers of cocaine-exp osed preterm neonates visited, touched, held, and fed their infants le ss frequently than mothers of nonexposed infants. Results. The cocaine -exposed infants had smaller head circumferences at birth, spent more time in the neonatal intensive care unit, and had a greater incidence of periventricular-intraventricular hemorrhages. They also had inferio r Brazelton cluster scores, including lower state regulation and range -of-state scores, and greater depression. During sleep-wake behavior o bservations, they showed difficulty maintaining alert states and self- regulating their behavior, and they spent more time in indeterminate s leep and had decreased periods of quiet sleep and increased levels of agitated behavior, including tremulousness, mouthing, multiple limb mo vements, and clenched fists. Finally, higher urinary norepinephrine, d opamine, and cortisol levels and lower plasma insulin levels were note d in the cocaine-exposed preterm neonates. Conclusions. These findings highlight the need for follow-up assessments and early intervention.