Comparison of cocaine and opiate exposures between young urban and suburban children

Motor development of cocaine-exposed children at age two years

OBJECTIVE

This article was designed to investigate effects of prenatal cocaine exposure on motor development of young children from a predominately underprivileged, urban population.

METHODOLOGY

A total of 260 infants and young children were initially recruited from either the newborn nursery or the at-risk pediatric clinic of an urban teaching hospital. Prenatal history and birth outcomes were collected from medical records. Demographic characteristics and additional drug histories were obtained from the mothers. The 199 subjects (98 cocaine-exposed and 101 unexposed) who returned at age 2 years were assessed by examiners blinded to drug exposure status using the Peabody Developmental Motor Scales.

RESULTS

Compared with control subjects, the cocaine-exposed group performed significantly less well on both the fine and the gross motor development indices. Mean scores for both groups were within the average range on the gross motor index, but greater than 1 standard deviation below average on the fine motor index. Differences were significant on the balance and the receipt and propulsion subscales of the gross motor scale, and on the hand use and the eye-hand coordination subscales of the fine motor scale. Cocaine status independently predicted poorer hand use and eye-hand coordination scores. There also was an effect of alcohol exposure on the receipt and propulsion subscale.

CONCLUSIONS

Findings indicate that deficiencies in motor development remain detectable at 2 years of age in children exposed to drugs prenatally. Although other environmental variables may influence motor development, children exposed to cocaine and to alcohol in utero may encounter developmental challenges that impede later achievement.

Cocaine in hair, saliva, skin swabs, and urine of cocaine users' children

The concentrations of cocaine and benzoylecgonine (BE) in the hair, saliva, skin secretions, and urine samples of cocaine-using mothers, their children, and other adults living in the same environment were compared. Subjects were screened from urban cocaine dependence treatment patients. Drug using adults had mean hair concentrations of 2.4 ng cocaine/mg hair (range = 0-12.2, sigma = 3.1, 15/16 positive) and 0.39 ng BE/mg hair (range = 0-1.9, sigma = 0.62), compared with children's mean hair concentrations of 2.4 ng cocaine/mg of hair (range = 0-14.4, sigma = 3.8, 22/24 positive) and 0.74 ng benzoylecgonine/mg hair (range = 0-5.4 sigma = 1.3). None of the children's urine specimens (0/22) were positive above 300 ng BE/ml. In contrast, 3/16 adult urine specimens were positive, even though they were enrolled in drug treatment. Saliva had detectable levels of BE for only one child (1/17) and one adult (1/17). Forehead swabs contained measurable quantities of cocaine for most children (19/26) and adults (15/17) and BE for children (7/26) and adults (7/17). Unlike urine results, overall hair cocaine concentrations for adults paralleled those of children and a clear cut-off concentration could not be established to differentiate these two groups.