Serious negative impact of cocaine found in subtle areas of attention, behavior control
Children exposed to cocaine in the womb face serious consequences from the drug, but fortunately not in certain critical physical and cognitive areas as previously believed, according to a new comprehensive review of research on the subject from scientists at the University of Maryland School of Medicine. When a pregnant woman uses cocaine, it can interrupt the flow of nutrients and oxygen to the baby, putting such children at risk for premature birth, low birth weight and many other problems. The new review of multiple major studies conducted on cocaine-exposed, school-aged children found this negative impact significantly affected children in subtle areas such as sustained attention and self-regulated behavior. The research, however, showed surprisingly little impairment directly from cocaine in key areas such as growth, IQ, academic achievement and language functioning.
Many of the children did have low IQ and poor academic and language achievement. The research suggested, though, that these apparent impairments were often caused by the troublesome home environment that goes along with cocaine use, rather than directly from the cocaine itself.
The developmental areas that the cocaine exposure seemed to directly impact - sustained attention and self-regulated behavior - could become significantly problematic as children grow into adults. The review is published this month in the journal Pediatrics. It is the first review of cocaine-exposed school-age children six and older; a previous review looked at younger children.
When rates of cocaine use began to grow in America in the 1980s, there was concern that children who had been exposed to the drug or its derivative, crack cocaine, in utero were doomed for a lifetime of poor health, sub-par performance in school, behavior problems and eventually for substance abuse themselves. The new review indicates otherwise, and could change the way medicine and social science approach outreach to and study of cocaine-exposed children, according to senior author Maureen M. Black, Ph.D., professor of pediatrics at the University of Maryland School of Medicine.
"Cocaine can disrupt fetal growth and development, but this review tells us that just because a child has been exposed to cocaine, it is not a foregone conclusion that they're going to be in trouble," says Dr. Black. "No one is saying cocaine use is good. We need prevention programs so women don't use cocaine in the first place. Children experience serious negative effects from drug exposure in the womb. It looks, though, as if cocaine doesn't work alone. Women who use cocaine are often from poor and dysfunctional families, where children do not receive the care and enrichment they need. In addition, women who use cocaine while pregnant often smoke cigarettes and drink alcohol as well, exposing their unborn children to legal substances with extremely negative consequences."
Dr. Black and her colleagues reviewed 32 major studies of school-age children, ages six through their teenage years, conducted between 1980 and 2008. All of the studies compared children who had been exposed to cocaine to those who had not. Dr. Black and postdoctoral fellows John P. Ackerman, Ph.D., and Tracy Riggins, Ph.D., aggregated the data and organized them into charts comparing the healthy children to those who had been exposed to cocaine.