Pregnancy and Cocaine – A Bad Idea

Cocaine and drug usage during pregnancy increases risk of child behavioral problems

(RxWiki News) It's challenging enough to raise headstrong toddlers. But toddlers and older kids whose mothers used cocaine during pregnancy? Their behavior can be especially difficult.

A recent study found that a mother's use of cocaine and other drugs during pregnancy leads her child to have significant behavioral problems. These problems include aggression, rule-breaking and attention difficulties.

Some positive effects can offset these behavior problems, like resilience in a child and a secure family environment. However, most children exposed to cocaine and other drugs will show some behavior problems.

"Don't use illegal drugs while pregnant."

The study, led by Henrietta S. Bada, MD, MPH, in the Department of Pediatrics at the University of Kentucky's College of Medicine, looked at the long-term impact on child behavior of a mother's drug use during pregnancy. The researchers followed 1,022 children from birth through age 15 who fell into one of four categories, including those whose mothers did not use any drugs while pregnant.

The other three categories including mothers who used a great amount of cocaine and other drugs during pregnancy, those who used some cocaine and other drugs during pregnancy and those who used other drugs but not cocaine during pregnancy.

The researchers assessed the children's behavior using a parent-reported questionnaire that looked at externalizing and internalizing behaviors, as well as attention problems and overall behavior. Externalizing behavior problems include different kinds of acting out, such as aggression, antisocial behavior, hyperactivity and frequently breaking rules (or laws).

Internalizing behavior problems include issues that arise when children hold in their emotions, such as being anxious, depressed or withdrawn. Children with internalizing problems may also sulk, avoid talking or be particularly shy.

Unsurprisingly, the children whose mothers frequently used cocaine and other drugs during pregnancy were much more likely to have externalizing problems and overall behavior and attention problems.

Women who used cocaine and drugs while pregnant but at lower amounts also had children with externalizing problems and attention difficulties. The mothers who used some drugs but not cocaine had children who experienced overall behavioral problems, but they were less likely to have internalizing problems, such as anxiety or depression.

Importantly, the researchers identified a variety of factors that helped reduce the problems in children's behavior, regardless of whether their mothers used drugs while pregnant or not. Children with greater resilience were more likely to behavior better, and children with lots of friends were less likely to have internalizing or attention problems, especially as they got older.

Children growing up in families with sufficient resources, including food, shelter, transportation, finances and family time, were also less likely to have behavior problems of all kinds except externalizing problems. The researchers also found that the more involved the children's parents (or caretakers) were, the fewer behavior difficulties the children had.

A supportive and involved family with sufficient resources will not completely remove the risk of behavior problems a child has if he or she was exposed to cocaine or other drugs while in the womb.

However, these positive factors, along with a strong social network, do appear to help lessen the behavioral problems.

The only factor that seems to completely offset some children's risk for behavior problems despite prenatal drug exposure was the characteristic of resilience. Particularly resilient children did okay regardless of exposure.

However, resilience is not a trait that all children will have or that all children will necessarily develop.

The study was published November 26 in the journal Pediatrics. The research was funded by the National Institute on Drug Abuse, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Mental Health, the Administration on Children, Youth and Families and the Center for Substance Abuse and Treatment within the US Department of Health and Human Services. The authors declared no conflicts of interest.

Review Date: 
November 23, 2012