Effects of prenatal cocaine/crack and other drug exposure on electroencephalographic sleep studies at birth and one year

Objective. Little is known about the neurophysiologic effects of prenatal c ocaine/crack use. The aim of this study, designed to overcome methodologic limitations of previous research, was to investigate the effects of prenata l cocaine use on electroencephalographic (EEG) sleep patterns, a marker of central nervous system development. Methods. In a longitudinal study of prenatal cocaine/crack exposure, women were interviewed at the end of each trimester about cocaine, crack, alcohol , tobacco, marijuana, and other drug use. Two-hour paper- and computer-gene rated EEG sleep recordings were obtained on a sample of the full-term infan ts on the second day of life and at 1 year postpartum. Eligible newborns we re fullterm, had received no general anesthesia, and had a 5-minute Apgar s core >5. All infants whose mothers used one or more lines of cocaine during their first trimester or any crack (n = 37) were selected. A comparison gr oup was chosen randomly from the group of women who did not use cocaine or crack during their pregnancy (n = 34). Results. Women who used cocaine/crack during the first trimester were older , less educated, less likely to be working, and used more tobacco, alcohol, marijuana, and other illicit drugs than women who did not use cocaine/crac k during the first trimester. There were no differences in infant birth wei ght, length, head circumference, or gestational age between the two exposur e groups. After controlling for the significant covariates, prenatal cocain e exposure was associated with less well developed spectral correlations be tween homologous brain regions at birth, and with lower spectral EEG power values at 1 year of age. Prenatal alcohol, marijuana, and tobacco use were found to affect state regulation and cortical activities. Conclusions. These results indicate that the neurotoxic effects of prenatal cocaine/crack use can be detected with quantitative EEG measures.