Neurobehavioral outcomes of cocaine-exposed infants

The present study investigated the neurobehavioral outcomes of fetal cocain e exposure. Attempts were made to control, by design or statistical analysi s, for significant confounders. Timing and amount of drug exposures were co nsidered, and biologic measures of exposure were quantified to classify exp osure severity. One hundred sixty-one non-cocaine and 158 cocaine-exposed ( 82 heavily and 76 lightly exposed) infants were seen at a mean-corrected ag e of 43 weeks post-conception and administered the Neurobehavioral Assessme nt (NB Assessment). Heavily cocaine - exposed infants had more jitteriness and attentional problems than lightly and non-exposed infants. They also ha d more movement and tone abnormalities, and sensory asymmetries than non-ex posed infants. Heavily exposed infants were more likely to be identified wi th an abnormality than non-exposed infants and then was a trend toward heav ily exposed infants being more likely to be identified with an abnormality than lightly exposed infants. Furthermore, there was a trend for heavily ex posed infants to be less likely to be testable than non-exposed infants. Af ter the confounding and mediating factors were considered, heavily cocaine- exposed infants were four times as likely to be jittery and nearly twice as likely to demonstrate any abnormality than lightly and non-exposed infants , but all other effects were no longer significant. Higher concentrations o f the cocaine metabolites of cocaine, cocaethylene, and benzoylecgonine (BZ E) were related to higher incidence of movement and tone abnormalities, jit teriness, and presence of any abnormality. Higher cocaethylene levels were related to attentional abnormalities and higher meta-hydroxybenzoylecgonine (m-OH-BZE) was related to jitteriness. Drug effects on attention were medi ated by maternal psychological distress, suggesting that this factor should be considered in future studies of drug exposure effects. (C) 2000 Elsevie r Science Inc. All rights reserved.