Prenatal Drug Exposures
/Enough with the Alcohol Already… Other Prenatal Drug Exposures:
Prenatal Drug Research in General
• Impossible to fully control for genetic (cognitive, mental health), other prenatal exposures, LBW/prematurity, and environmental factors• Alcohol may be cofounder in many studies
• Prenatal drug exposure may make kids more vulnerable to other biomedical and environmental risks
Tobacco
• BIG association with low birth weight• Higher rates of spontaneous abortion, late fetal deaths, prematurity, cleft lip
• SIDS, ear infections, asthma, etc …
• Impaired infant state regulation
• Assoc with lower mental scores/babbling @1yo – cognitive effects minimal by 2yo
• More externalizing behaviors and inattention/hyperactivity
Marijuana
• Modest effect on fetal growth (hypoxia)• Some subtle infant neurobehavior effects
• No cognitive /language effects at 1-2yo
• Memory and verbal outcomes at 4yo possibly impacted by heavy prenatal exposure
• Some impact on motor development as well
Opiates (heroin, methadone)
• Low Birthweight (more with heroin)• Newborn withdrawal syndrome: jitters/tremor, hypertonia, irritability, high-pitched cry, convulsions, stuffiness, fever, mottling, sweating, loose stools/vomiting, poor feeding
• Treated with slow opiate taper
• “Subacute withdrawal” – 3-6mo with irritability, poor state control
• Subtle late differences in visual-motor and perceptual tasks
Cocaine and Crack
• Spont abortion, abruption, stillbirths, prematurity, distress (vasoconstriction)
• Neonatal stokes, focal seizures
• Urogenital and other malformations
• Microcephaly
• Early excitability/irritability in infancy
• Preschool impulse control issues
• No cognitive differences on broad scales ...
• Subtle differences in specific functions (state regulation, lang, attn/impulsivity, visual memory, temperament, aggression)
Speed and Meth
• Sharp rise in the 90s, especially rural
• Meth labs – bigtime fire and chemical risks
• Preterm delivery, abruption
• LBW, cardiac and cleft defects, smaller subcortical brain volumes
• Not much data on developmental effects
• Visual memory, verbal memory, executive function, attention/impulsivity, and long-term spatial memory may be affected
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