Longitudinal Studies of the Effects of Prenatal Cocaine Exposure on Development and Behavior

Abstract This chapter describes methodological challenges in studying the effects of prenatal cocaine exposure (PCE), including issues of sample selection, assessment of substance use, selection of appropriate comparison groups, and measurement of covariates. The Maternal Health Practices and Child Development Project, an ongoing longitudinal study investigating the long-term consequences of PCE, is described, followed by a review of findings from that study and other longitudinal studies of PCE. Associations between PCE and growth are inconsistent, with some studies reporting negative relations and others reporting no association. Most studies report that global cognitive development is not associated with PCE, although there are specific areas of central nervous system and cognitive development that are negatively affected by PCE. The most consistently reported associations are between PCE and behavior problems, such as aggression, delinquency, and substance use. Continued follow-up of these longitudinal cohorts into early and midadulthood is important to evaluate whether the observed deficits continue to increase or whether there is some amelioration with maturation, and what factors are associated with different developmental patterns.