NEW EVIDENCE FOR NEUROBEHAVIORAL EFFECTS OF IN-UTERO COCAINE EXPOSURE

Most studies of prenatal cocaine exposure have found gestational age o r intrauterine growth deficits but few, if any, cognitive effects. In a large, well-controlled study we detected cognitive deficits in relat ion to heavy cocaine exposure. These findings demonstrate that prenata l exposure to cocaine at sufficiently high doses early in pregnancy ha s the potential to produce cognitive changes in infants and that more focused, narrow-band tests may be necessary to detect these subtle neu robehavioral effects. A total of 464 inner-city, black infants whose m others were recruited prenatally on the basis of pregnancy alcohol and cocaine use were tested at 6.5, 12, and 13 months of age. Standard an alyses, based on presence or absence of cocaine use during pregnancy, confirmed effects on gestational age but failed to detect cognitive ef fects. A new approach to identifying heavy users found that heavy expo sure early in pregnancy was related to faster responsiveness on an inf ant visual expectancy test but to poorer recognition memory and inform ation processing, deficits consistent with prior human and animal find ings, These persistent neurobehavioral effects of heavy prenatal cocai ne exposure appear to be direct effects of exposure and independent of effects on gestational age.