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Am J Perinatol
DOI: 10.1055/a-2090-5293
Original Article

Prenatal Substance Exposure: Associations with Neurodevelopment in Middle Childhood

Elisabeth Conradt
1   Departments of Psychiatry and Pediatrics, Duke University, Durham, North Carolina
,
Monica McGrath
2   Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland
,
Emily Knapp
2   Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland
,
Xiuhong Li
2   Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland
,
Rashelle J. Musci
2   Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland
,
Maxwell Mansolf
3   Department of Psychology, University of California, Los Angeles, California
,
Sean Deoni
4   Memorial Hospital of Rhode Island, Pawtucket, Rhode Island
5   Department of Pediatrics, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island
,
Sheela Sathyanarayana
6   Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
7   Department of Pediatrics, University of Washington, Seattle, Washington
,
Steven J. Ondersma
8   Division of Public Health and Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Flint, Michigan
,
Barry M. Lester
9   Women and Infants Hospital of Rhode Island, Providence, Rhode Island
10   Brown Center for the Study of Children at Risk, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
,
on behalf of program collaborators for Environmental Influences on Child Health Outcomes › Author Affiliations Funding This work was supported by the Environmental Influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health, under Award Numbers U2COD023375 (Coordinating Center), U24OD023382 (Data Analysis Center), U24OD023319 (PRO Core), and UH3OD023347 (Lester), UH3OD023347 (McEvoy), 4UH3OD023271-03 (Karr, Sathyanarayana), UH3 OD023285 (Paneth), 4UH3OD023282-03 (Gern). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Abstract

Objective Single-substance exposure effects on neurodevelopmental outcomes, such as problem behavior and intelligence quotient (IQ), have been studied in children for decades. However, the long-term consequences of polysubstance exposure are poorly understood.

Study Design Longitudinal neurodevelopmental data were gathered from cohorts across the United States through the Environmental Influences on Child Health Outcomes Program. Data on prenatal exposure to opioids, nicotine, marijuana, and alcohol were collected from children ages 6 to 11 years (N = 256). Problem behavior was assessed using the Child Behavior Checklist (school-age version), and verbal IQ (VIQ) and performance IQ (PIQ) were assessed using the Weschler Intelligence Scale for Children, Fifth Edition. We first identified latent profiles in the overall sample, then evaluated differences in profile membership for children with and without prenatal substance exposure.

Results Latent profile analysis identified two mutually exclusive categories: average VIQ and PIQ, with typical problem behavior, and below-average VIQ with average PIQ and clinically significant problem behavior. Children with prenatal nicotine and polysubstance exposures were more likely to be classified in the below-average VIQ, elevated problem behavior profile compared with children without prenatal nicotine exposure.

Conclusion The presence of clinically significant behavior problems in children with average PIQ, but below-average VIQ, could represent a unique endophenotype related to prenatal nicotine exposure in the context of other prenatal substance exposures.

Key Points

  • The neurodevelopmental consequences of prenatal polysubstance exposure are poorly understood.

  • Children with prenatal polysubstance exposure exhibited reduced IQ and elevated problem behavior.

  • We found significant behavior problems in children with average PIQ and below-average VIQ.

  • This may represent a unique endophenotype related to prenatal nicotine exposure.

Keywords

prenatal polysubstance exposure - problem behavior - intelligence - pregnancy

Authors' Contributions

E.C., M. McGrath, E.K., X.L., R.J.M., M. Mansolf, S.D., S.S., S.J.O., and B.M.L. made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data, contributed to drafting the article, and revising it critically for important intellectual content, and all authors approved the final version to be published.


Ethical Approval and Consent to Participate

The study protocol was approved by the local and/or central ECHO Institutional Review Board.


Written informed consent or parent's/guardian's permission was obtained along with child assent as appropriate.


Data Availability Statement

Deidentified data from the ECHO Program are available through NICHD's Data and Specimen Hub (DASH). DASH is a centralized resource that allows researchers to access data from various studies via a controlled-access mechanism. Researchers can now request access to these data by creating a DASH account and submitting a Data Request Form. The NICHD DASH Data Access Committee will review the request and provide a response in approximately 2 to 3 weeks. Once granted access, researchers will be able to use the data for 3 years. See the DASH Tutorial for more detailed information on the process.


* See Acknowledgments for full listing of collaborators.




Publication History

Received: 31 January 2023

Accepted: 04 May 2023

Accepted Manuscript online:
10 May 2023

Article published online:
26 June 2023

© 2023. Thieme. All rights reserved.

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