Prenatal cocaine exposure and small-for-gestational-age status: Effects on growth at 6 years of age

ObjectiveTo evaluate the impact of prenatal cocaine exposure and small-for-gestational-age (SGA) status on childhood growth.Study designCocaine exposure was defined by history or meconium metabolites. Hierarchical linear modeling was used to examine cocaine exposure and SGA status on growth, while controlling for exposure to other drugs and alcohol use.ResultsAt birth cocaine-exposed infants (n = 364) had significantly lower growth parameters compared to non-exposed children (n = 771). At 6 years, weight was similar between exposed and unexposed children. SGA infants continued to be growth impaired. There was a significant interaction between prenatal cocaine exposure and SGA status at 6 years. The negative effects of cocaine on weight and height were greater among non-SGA than SGA children (432 vs. 280 gm, and 0.7 and 0.5 cm, respectively) while negative effects of SGA status on weight and height were larger in non-cocaine exposed compared to the exposed children (2.3 kg vs.1.6 kg and 2.2 and 1.0 cm).ConclusionsChildren exposed to prenatal cocaine were similar in weight to non-exposed children at 6 years of age. Cocaine had an unexplained greater detrimental effect on non-SGA than SGA children. SGA status at birth has an independent detrimental effect on childhood growth.

► Prenatal cocaine exposure has impact on childhood growth.
► This is the first study to examine interaction of small-for-gestational age status and prenatal cocaine exposure.
► Negative effects of small-for-gestational age status at birth was greater in non-cocaine exposed than cocaine-exposed children.
► Negative effects of cocaine exposure was greater in appropriate-for-gestational age than small-for-gestational age children.