Prenatal drug exposure

Infant and toddler outcomes

Emmalee S Bandstra, Connie E Morrow, Elana Mansoor, Veronica H Accornero

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

This manuscript provides an overview of the current scientific literature on the impact of maternal drug use, specifically opioids and cocaine, during pregnancy on the acute and long-term outcomes of infants and toddlers from birth through age 3 years. Emphasis with regard to opioids is placed on heroin and opioid substitutes used to treat opioid addiction, including methadone, which has long been regarded as the standard of care in pregnancy, and buprenorphine, which is increasingly being investigated and prescribed as an alternative to methadone. Controlled studies comparing methadone at high and low doses, as well as those comparing methadone with buprenorphine, are highlighted and the diagnosis and management of neonatal abstinence syndrome is discussed. Over the past two decades, attention of the scientific and lay communities has also been focused on the potential adverse effects of cocaine and crack cocaine, especially during the height of the cocaine epidemic in the United States. Herein, the findings are summarized from prospective studies comparing cocaine-exposed with non-cocaine-exposed infants and toddlers with respect to anthropometric growth, infant neurobehavior, visual and auditory function, and cognitive, motor, and language development. The potentially stigmatizing label of the so-called crack baby preceded the evidence now accumulating from well-designed prospective investigations that have revealed less severe sequelae in the majority of prenatally exposed infants than originally anticipated. In contrast to opioids, which may produce neonatal abstinence syndrome and infant neurobehavioral deficits, prenatal cocaine exposure appears to be associated with what has been described as statistically significant but subtle decrements in neurobehavioral, cognitive, and language function, especially when viewed in the context of other exposures and the caregiving environment which may mediate or moderate the effects. Whether these early findings may herald more significant learning and behavioral problems during school-age and adolescence when the child is inevitably confronted with increasing social and academic challenges is the subject of ongoing longitudinal research.

Original languageEnglish
Pages (from-to)245-258
Number of pages14
JournalJournal of Addictive Diseases
Volume29
Issue number2
DOIs
StatePublished - Apr 1 2010

Fingerprint

Cocaine
Opioid Analgesics
Methadone
Neonatal Abstinence Syndrome
Buprenorphine
Pharmaceutical Preparations
Cognition
Crack Cocaine
Literature
Pregnancy
Language Development
Heroin
Standard of Care
Language
Mothers
Learning
Parturition
Prospective Studies
Growth
Research

Keywords

  • Buprenorphine
  • Cocaine
  • Heroin
  • Infant
  • Methadone
  • Pregnancy

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Prenatal drug exposure : Infant and toddler outcomes. / Bandstra, Emmalee S; Morrow, Connie E; Mansoor, Elana; Accornero, Veronica H.

In: Journal of Addictive Diseases, Vol. 29, No. 2, 01.04.2010, p. 245-258.

Research output: Contribution to journalArticle

Bandstra, Emmalee S ; Morrow, Connie E ; Mansoor, Elana ; Accornero, Veronica H. / Prenatal drug exposure : Infant and toddler outcomes. In: Journal of Addictive Diseases. 2010 ; Vol. 29, No. 2. pp. 245-258.
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