Prenatal Substance Exposure: Associations with Neurodevelopment in Middle Childhood

Author:

Conradt Elisabeth1,McGrath Monica2,Knapp Emily2,Li Xiuhong2,Musci Rashelle J.2,Mansolf Maxwell3,Deoni Sean45,Sathyanarayana Sheela67,Ondersma Steven J.8,Lester Barry M.910,

Affiliation:

1. Departments of Psychiatry and Pediatrics, Duke University, Durham, North Carolina

2. Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland

3. Department of Psychology, University of California, Los Angeles, California

4. Memorial Hospital of Rhode Island, Pawtucket, Rhode Island

5. Department of Pediatrics, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island

6. Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington

7. Department of Pediatrics, University of Washington, Seattle, Washington

8. Division of Public Health and Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Flint, Michigan

9. Women and Infants Hospital of Rhode Island, Providence, Rhode Island

10. Brown Center for the Study of Children at Risk, Women and Infants Hospital of Rhode Island, Providence, Rhode Island

Abstract

Objective Single-substance exposure effects on neurodevelopmental outcomes, such as problem behavior and intelligence quotient (IQ), have been studied in children for decades. However, the long-term consequences of polysubstance exposure are poorly understood.Study Design Longitudinal neurodevelopmental data were gathered from cohorts across the United States through the Environmental Influences on Child Health Outcomes Program. Data on prenatal exposure to opioids, nicotine, marijuana, and alcohol were collected from children ages 6 to 11 years (N = 256). Problem behavior was assessed using the Child Behavior Checklist (school-age version), and verbal IQ (VIQ) and performance IQ (PIQ) were assessed using the Weschler Intelligence Scale for Children, Fifth Edition. We first identified latent profiles in the overall sample, then evaluated differences in profile membership for children with and without prenatal substance exposure.Results Latent profile analysis identified two mutually exclusive categories: average VIQ and PIQ, with typical problem behavior, and below-average VIQ with average PIQ and clinically significant problem behavior. Children with prenatal nicotine and polysubstance exposures were more likely to be classified in the below-average VIQ, elevated problem behavior profile compared with children without prenatal nicotine exposure.Conclusion The presence of clinically significant behavior problems in children with average PIQ, but below-average VIQ, could represent a unique endophenotype related to prenatal nicotine exposure in the context of other prenatal substance exposures.Key Points

Funder

Office of The Director, National Institutes of Health

Publisher

Georg Thieme Verlag KG

Subject

Obstetrics and Gynecology,Pediatrics, Perinatology and Child Health

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