Effects of prenatal cocaine exposure on child behavior and growth at 10 years of age

• We examined child growth and behavior in a longitudinal study of prenatal cocaine use.
• First trimester cocaine use predicted decreased growth at 10 years.
• First trimester cocaine use predicted mother, teacher, and child ratings of behavior.
• Child exposure to violence influenced the effect of prenatal cocaine use on some behaviors.
• These behaviors may have implications for later psychiatric problems.

We examined physical growth and behavioral outcomes in 226 10-year-old children who were participants in a longitudinal study of prenatal cocaine exposure (PCE), while controlling for other factors that affect development. During the first trimester, 42% of the women used cocaine, with use declining across pregnancy. At the 10-year follow-up, the caregivers were 37 years old, had 12.8 years of education, and 50% were African American. First trimester cocaine exposure predicted decreased weight, height, and head circumference at 10 years. First trimester cocaine use also predicted maternal ratings of less sociability on the EAS Temperament Survey and more withdrawn behavior problems on the Child Behavior Checklist, more anxious/depressed behaviors on the Teacher Report Form, and more self-reported depressive symptoms on the Children's Depression Inventory. In addition, exposure to violence mediated the effect of PCE on child and teacher reports of depressive symptoms, but not of maternal reports of sociability and withdrawn behaviors. These behaviors may be precursors of later psychiatric problems.