Abstract 1393 Neurodevelopmental Disabilities Poster Symposium, Tuesday, 5/4

Public sentiment suggests that cocaine has toxic/teratogenic potential, but scientific studies have not shown consistent support for this view. This four site study was designed to assess differences between C/O exposed infants (as assessed by maternal history and/or meconium assay) and comparison infants (matched by gestational age, sex, and race). Infants were predominantly full term (62%), African-American (77%), with 83% of mothers receiving Medicaid. The Bayley Scales of Infant Development II (Bayley, 1993) were administered at one and two years corrected age by masked, certified examiners. For the C/O-Comparison cohorts, respectively, compliance was 77%-73% at one year and 74%-72% at two years on the Mental Development Index (MDI). Infants with MDI scores at both ages or PDI scores at both ages were included in the analyses. C/O exposure was associated with a two point deficit in mental but not motor performance at one year (Ped Res, 43:222A, 1998). At two years of age (see MDI Figure), there was no difference in mean MDI between the 474 comparison (82.3±13.9) and the 400 C/O (81.5±12.7) infants (p=.4). Change scores (1 year MDI minus 2 year MDI) showed a sharp drop in performance (M=9.5±14.1, p < .0001) that was also not associated with C/O exposure (p=.3). At two years (see PDI figure) there was no difference in mean PDI between the 426 comparison (95.4±15.0) and 360 C/O infants (94.7±13.8) (p=.5). Change scores showed a rise in PDI performance (M=4.7±15.0, p < .0001) that was not associated with C/O exposure (p=.2). In a large at-risk sample matched on key variables, C/O exposure was not associated with mental and motor performance at two years or with changes in performance between one and two years. An increase in PDI for both C/O and comparison groups may reflect catch-up toward a census-normed mean of 100 in motor performance. A sharp decline in mental performance for both groups may reflect difficulties with verbal and cognitive test items at two years.

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