Prenatal Cocaine Exposure and Infant Performance on the Brazelton Neonatal Behavioral Assessment Scale

Abstract

Drug-exposed infants did not differ from nonexposed infants on Neonatal Behavioral Assessment Scale (NBAS) clusters or on birth characteristics. Infants (n = 137) born to three groups of low-income mothers—cocaine and poly-drug-using mothers in a drug user treatment group (n = 76) and in a treatment rejecter group (n = 18), and to a nonuser group (n = 43)—were examined at 2 days and 2–4 weeks. The motor cluster improved and regulation of state worsened from time 1 to 2. There were no interactions of group by time. Regression analyses were conducted to see whether group differences might either emerge or disappear after removing effects of competing variables, but they did not. Power analysis showed that sample size was sufficient to have detected group differences.

• Prenatal drug exposure
• Prenatal cocaine exposure
• Maternal substance use
• Infant behavior
• NBAS (Neonatal Behavioral Assessment Scale)

Resumen

Al ser comparados infantes nacidos de madres que usarón sustancias psicoactivas durante el embarazo con infantes nacidos de madres sin problemas con drogas, los resultados no identificarón diferencias significativas en subgrupos de NBA ó características del infante durante el nacimiento. Tres grupos de infantes de madres de bajos recursos económicos (n = 137) fuerón analizados a los dos días, segunda, y cuarta semana después del nacimiento. El primer grupo lo constituyerón infantes de madres que usarón cocaina o múltiples sustancias psicoactivas (n = 76), el segundo grupo infantes de madres que rechazarón el tratamiento (n = 18), y el tercer grupo infantes de madres que no usarón drogas. Los resultados mostrarón como el desarrollo motor y regulatorio empeorarón al analizar los grupos longitudinalmente en dos ocasiones. Al llevar a cabo analisis de regresión múltiple, no se encontrarón interacciones por grupo y tiempo ó diferencias entre los grupos debido a variables de confusión que pudieran haber competido en el modelo. Finalmente, el tamaño de muestra fué considerado como suficiente despues de realizar análisis de poder muestral.

Résumé

Les bébés exposés aux stupéfiants ne diffèrent pas des bébés non-exposés dans les groupes NBAS (barème d’évaluation du comportement néonatal). Les bébés (n = 137) nés de trois groupes de mères pauvres, cocaïnomanes et toxicomanes, dans un groupe de traitement (n = 76), dans un groupe refusant le traitement (n = 18) et dans un groupe non-consommateur (n = 43)—ont été examinés à l’âge de deux jours et de deux à quatre semaines. Le groupe moteur s’est amélioré et la régulation de la condition a empiré de fréquence 1 à 2. Il n’y a eu aucune interaction de groupe par fréquence. Des analyses de régression ont été menées pour déterminer si des différences entre les groupes apparaîtraient ou disparaîtraient une fois éliminés les effets des variables en concurrence, mais cela n’a pas été le cas. Une analyse de puissance a montré que la grandeur de l’échantillon était suffisante pour permettre de découvrir des différences entre les groupes.

Additional information

Notes on contributors

Barbara J. Myers

Barbara J. Myers received her Ph.D. in Developmental Psychology from Temple University. She is Assoc. Professor of Psychology and Director of the Developmental Division at Virginia Commonwealth University. She does research and programming with incarcerated mothers, their children, and the grandparents and other relatives who are the children's caregivers.

Kathryn S. Dawson

Kathryn Dawson received her Ph.D. in Biostatistics from Virginia Commonwealth University in 1995, where she is now Assistant Professor of Biostatistics. She does research on clinical trial methodology and statistical applications in Bioinformatics.

Gena C. Britt

Gena Britt received her Ph.D. in Developmental Psychology from Virginia Commonwealth University in 1993, where she is now on faculty in the Psychiatry Department. She does research on the effects of prenatal substance exposure on infant and child development.

Diane E. Lodder

Diane E. Lodder received her Ph.D. in Developmental Psychology from Virginia Commonwealth University in 1994. She is Chair of Psychology/Sociology at Wake Technical Community College in Raleigh, NC.

Linda D. Meloy

Linda D. Meloy received her M.D. from Rutgers Medical School in 1981. She is now the Interim Division Chair of the Division of General Pediatrics at Virginia Commonwealth University Health Systems. Her research focuses on infants and their families. She is the primary investigator on a study involving the needs of infants with jaundice.

Martha K. Saunders

Martha Saunders received her M.D. from Virginia Commonwealth University Health Systems, the Medical College of Virginia. She now cares for children and their families in private practice as founding member of Huguenot Pediatrics in Midlothian, VA.

Stephanie L. Meadows

Stephanie L. Meadows received her Ph.D. in Biostatistics from Virginia Commonwealth University. She works at Pfizer, Inc., New London, CT, as a Coordinator in the Clinical Biostatistics group. She supports projects in the areas of allergy and inflammation.

R. K. Elswick

R. K. Elswick received his Ph.D. in Biostatistics from Virginia Commonwealth University, where he is Associate Professor of Biostatistics and Graduate Program Director. Dr. Elswick's research interests include clinical trial methodology, multivariate statistical methodology, longitudinal models and mixed effects models. Design and analysis of equivalence clinical trials is of specific interest. He is a co-investigator on two National Institutes of Health grants and serves as a consultant with pharmaceutical and industrial firms.