INCREASED INCIDENCE OF INTRAVENTRICULAR HEMORRHAGE AND DEVELOPMENTAL DELAY IN COCAINE-EXPOSED, VERY-LOW-BIRTH-WEIGHT INFANTS

This study sought to determine whether very low birth weight (VLBW) in fants (<1500 gm) with fetal cocaine exposure differed from non-cocaine -exposed VLBW infants in incidence of neonatal medical complications a nd in later developmental outcome. Forty-one cocaine-exposed, VLBW inf ants, followed in a longitudinal study, were compared with 41 non-coca ine-exposed, VLBW infants of comparable race, social class, age, and i ncidence of bronchopulmonary dysplasia. Cocaine-exposed infants were i dentified on the basis of combined findings of maternal and/or infant urine immunoassay and on the basis of maternal self-report. At birth, groups did not differ on medical risk factors except that cocaine-expo sed infants had a higher incidence of mild (grades I to II) intraventr icular hemorrhage. Cocaine-using women were also more likely to use ot her drugs, especially alcohol, marijuana, and tobacco. At follow-up, a t mean corrected ages of 16.5 +/- 8 months for 30 cocaine-exposed infa nts and 18.5 +/- 7 months for 37 non-cocaine-exposed infants, standard ized assessments of cognitive (Mental Development Index) and motor (Ps ychomotor Development Index) development were administered. Cocaine-ex posed infants had lower mean cognitive (83 +/- 27 vs 91 +/- 19), and m otor(85 +/- 25 vs 96 +/- 18) scores; the incidence of developmental de lay was significantly higher even after control for the effects of int raventricular hemorrhage and chronologic age. Cocaine-exposed VLBW inf ants were also more likely to be living with relatives or in foster ho mes. We conclude that these VLBW, cocaine-exposed infants were at incr eased risk of intraventricular hemorrhage, were more likely to be plac ed outside maternal care, and had higher incidences of cognitive and m otor delays at follow-up.