Article

Severity of prenatal cocaine exposure and child language functioning through age seven years: a longitudinal latent growth curve analysis.

Department of Pediatrics, University of Miami School of Medicine, Miami, Florida 33101, USA.
Substance Use &amp Misuse (impact factor: 1.1). 02/2004; 39(1):25-59. pp.25-59
Source: PubMed

ABSTRACT The current study estimates the longitudinal effects of severity of prenatal cocaine exposure on language functioning in an urban sample of full-term African-American children (200 cocaine-exposed, 176 noncocaine-exposed) through age 7 years. The Miami Prenatal Cocaine Study sample was enrolled prospectively at birth, with documentation of prenatal drug exposure status through maternal interview and toxicology assays of maternal and infant urine and infant meconium. Language functioning was measured at ages 3 and 5 years using the Clinical Evaluation of Language Fundamentals--Preschool (CELF-P) and at age 7 years using the Core Language Domain of the NEPSY: A Developmental Neuropsychological Assessment. Longitudinal latent growth curve analyses were used to examine two components of language functioning, a more stable aptitude for language performance and a time-varying trajectory of language development, across the three time points and their relationship to varying levels of prenatal cocaine exposure. Severity of prenatal cocaine exposure was characterized using a latent construct combining maternal self-report of cocaine use during pregnancy by trimesters and maternal and infant bioassays, allowing all available information to be taken into account. The association between severity of exposure and language functioning was examined within a model including factors for fetal growth, gestational age, and IQ as intercorrelated response variables and child's age, gender, and prenatal alcohol, tobacco, and marijuana exposure as covariates. Results indicated that greater severity of prenatal cocaine exposure was associated with greater deficits within the more stable aptitude for language performance (D = -0.071, 95% CI = -0.133, -0.009; p = 0.026). There was no relationship between severity of prenatal cocaine exposure and the time-varying trajectory of language development. The observed cocaine-associated deficit was independent of multiple alternative suspected sources of variation in language performance, including other potential responses to prenatal cocaine exposure, such as child's intellectual functioning, and other birth and postnatal influences, including language stimulation in the home environment.

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Keywords

176 noncocaine-exposed
 
200 cocaine-exposed
 
age 7 years
 
child's age
 
cocaine use
 
current study estimates
 
Developmental Neuropsychological Assessment
 
fetal growth
 
full-term African-American children
 
infant bioassays
 
infant meconium
 
language development
 
language stimulation
 
Longitudinal latent growth curve analyses
 
observed cocaine-associated deficit
 
prenatal alcohol
 
prenatal cocaine exposure
 
prenatal drug exposure status
 
three time points
 
toxicology assays