Previous studies have shown that cocaine taken by the pregnant mother can cross through to the baby via the placenta. Researchers have surmised that this exposure may result in central nervous system damage and later developmental problems in children. So far, however, the early predictions of devastating effects have not been realized.

Scientists at Albert Einstein Medical Center in Philadelphia administered developmental tests on two groups of inner-city children, 65 children who had experienced cocaine exposure in the womb and 68 who had not, to test whether the children’s development was affected by exposure to the drug.

"Although there is clearly a potential for an in utero drug effect, to date we have not found in utero cocaine exposure to be as important an influence as growing up in poverty in the inner city," said lead author Hallam Hurt, MD.

Hurt and colleagues measured the children’s social, motor, communication, adaptive and cognitive skills twice: at ages three and five.

At age three, the cocaine-exposed children had lower scores on the developmental test than those not exposed, but these scores were related to their caregiver and home environment, not their in utero cocaine exposure, the researchers found.

At age five, both groups had similar low scores on the developmental test. This time, scores were statistically related to the home environment only, not to caregiver issues or in utero cocaine exposure. The study results are published in the February 2001 issue of the journal Developmental and Behavioral Pediatrics.

In general, both groups of inner-city children scored poorly on the test, and their performance worsened as they got older. "Our results suggest inner-city children are at risk for adverse development regardless of in utero cocaine exposure," said Hurt.

Hurt and colleagues speculated as to why parents and the home environment were associated with children’s development at age three, while at age five only the home environment seemed to play a role. At age three, children need a tremendous amount of help from caregivers in order to learn a range of skills including socializing, eating, impulse control, toilet training and dressing.

The children seemed to learn these early skills more effectively from biological, rather than foster, parents. The authors suggest that biological parents may be more sensitive to a child’s needs, more loving and more tolerant. "Children in foster care may also have developmental problems because they are simultaneously struggling with separation and loss issues," noted Hurt.

At age five, when children are more physically coordinated and have better communication skills, stimulation from peers and other family members aside from the primary caregiver helps them thrive.

"At age five, the presence of the biologic parent in the home appears to be a less critical issue for development. What becomes increasingly important is the child’s learning experiences with all family members, not just those with the parent," concluded Hurt.

While Hurt and colleagues did not find differences between groups on this developmental test, they point out that extreme poverty may obscure more subtle effects of in utero cocaine exposure.

This study was supported by grants from the National Institute on Drug Abuse and the Albert Einstein Society.

Note: If no author is given, the source is cited instead.

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