Funding to extend prenatal cocaine exposure study

Thanks to a $2.5 million grant from the National Institute on Drug Abuse, a 21-year-old longitudinal study of the effects of cocaine exposure in utero will continue to follow its subjects into adulthood.

The grant will extend by 4 years Case Western Reserve University’s Project Newborn, which has followed more than 400 children born at MetroHealth Medical Center in Cleveland, Ohio, between September 1994 and August 1996 to predominantly black, low-income mothers. About half of the mothers had used cocaine during pregnancy, as assessed by maternal interview and urine test and a sample of the infants’ initial stool.

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Researchers evaluated growth and development in the 2 groups of children-prenatally cocaine-exposed (PCE) and non–cocaine-exposed (NCE)-at age 6 months, then at 1, 2, 4, 6, 9, 10, 11, 12, 15, and 17 years. Now that the remaining 358 of the original participants have grown up, the ongoing study will focus on outcomes such as rates of substance abuse, educational achievement, quality of relationships, and behavior.

In a study published last year, the researchers reported that prenatal cocaine exposure increased the likelihood of alcohol, tobacco, or other drug use before age 15 years compared with the nonexposed control group, after controlling for multiple potential confounding variables. Social and legal problems arising from drug use also were significantly more prevalent among the PCE than the NCE children.

The next phase of the research will examine whether the PCE group continue to have higher rates of drug use and whether their drug use escalates. It also will  monitor their education, relationships, and work.  

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Thus far, Project Newborn, undertaken in the wake of the crack cocaine epidemic of the 1990s, hasn’t borne out initial fears that prenatal cocaine exposure would cause permanent brain damage and serious functional impairment in adulthood. It has, however, found significant, subtle cognitive effects including attention deficits, learning difficulties, planning and organizational impediments, and behavior problems, in addition to early drug use.  

Earlier phases of Project Newborn found that placing children in a higher-quality home environment through foster care or adoption had a protective effect on cognitive outcomes. However, to the researchers’ surprise, the same effect didn’t apply to early substance use among adolescents in the latest study. Further research will be needed to explain why, they note. They speculate that cocaine’s neurotoxic effects or genetic factors related to substance use may overpower the protection afforded by higher-quality home environments in the case of drug-related adolescent risk-taking behavior.