Abstract 1388 Neonatology: Clinical Investigation Platform, Monday, 5/3

Little information exists on outcomes past the neonatal period of children to cocaine/opiates (EXP) in utero. The purpose of this study is to determine the 2-yr developmental status of children born to mothers who used cocaine/opiates during pregnancy. The MLS is a multi-site (Brown U, U of Miami, U of TN, Wayne State U) longitudinal follow-up study of EXP and their comparison non-exposed cohort (COMP), matched within site for gestational age, gender and race. A total of 1388 children were recruited and enrolled from 1993-1995 (EXP: n=658; COMP: n=730). The enrolled population for follow-up was comprised of 53.5% males and 10.8% with gestational age <33 weeks in the EXP compared to 51.9% males and 12.2% with gestational age <33 weeks in the COMP. Of those enrolled, 495 EXP and 558 COMP were evaluated at age 2 yr for growth, health, and developmental status. A large proportion (32.4%) of EXP were no longer living with mother versus 3% of COMP (p<.001). At 2 yr of age, 17% of EXP and 14% of COMP were less than 10th percentile for weight; 13% of EXP and 12% of COMP had head circumference less than 10th percentile. Since 1 yr visit, 82.4% of EXP and 83.3% of COMP have received well-child checkup. The table compares the groups as to growth, immunization status, percent of those with any sick child visit, ER visit, hospitalization since 1 yr of age, % with abnormal motor assessment, and median MDI and PDI on the Bayley Scales of Infant Development II. Exposed children tended to have lower utilization of health care services, especially sick child visits, ER visits and hospitalization. No significant difference was noted between groups on MDI and PDI. 38% of EXP and 42% of COMP had MDI ≥85; 76% of EXP and 77% of COMP had PDI ≥85. Median percentiles of behavior rating scales were the same in both groups, 33%, 38%, and 48%, respectively, for orientation/engagement, emotion regulation, and motor quality. Preliminary data from a large cohort of EXP and COMP children showed little difference between groups as to growth, health, and development. Mental performance of both EXP and COMP was unexpectedly low and similar to reported outcomes of medically high-risk, low birth weight children. (Table)

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