2.+Behavioral+Effects

= The behavioral effects of cocaine use during pregnancy =

One might argue that behavioral effects are one of the most important effects to look into when studying prenatal cocaine exposure. Research seems to suggest that prenatal cocaine exposure has a negative effect on behavior, both short and long term, in infants and children.



Lewis and Bendersky (1995) developed a model to explain the behavioral effects of cocaine on infants who are exposed in-utero to the drug (see the diagram to the right). First, we begin with a exposure to a drug such as cocaine. This hinders neuro-regulatory mechanisms: "we do know that developmental exposure to cocaine alters several neurochemical measures related to the dopamine system (p. 23)." This in turn causes disorders in behavioral regulation, affecting the "Four A's of Infancy", which are attention, arousal, affect, and action (Lewis & Bendersky, 1995, p. 23). This model suggests definite behavioral effects involved with prenatal exposure to cocaine.



Other research has suggested effects on infant behavior when exposed to cocaine. Scafidi et al. (1996) did many tests to see the behavorial differences that set these infants apart from other infants. They found that cocaine-exposed infants displayed greater depression and more difficulty self-regulating their behavior. These infants also had decreased periods of quiet sleep, more agitated behavior (trembling, limb movements, clenched fists), and difficulty maintaining an alert state. Richardson, Goldschmidt and Willford (2009) also found that infants exposed to cocaine during their first semester scored higher on the fussy/difficult scales, and became more fussy over time.

The effect of prenatal exposure to cocaine on infants seems to be clear on a behavioral level. However, one might wonder if these types of effects can carry on into later in life. The following studies looked into older children's behavior when they were exposed to cocaine in-utero.



Various studies have suggested an effect on behavior in older children. Richardson, Goldschmidt and Willford (2009) Found that children exposed to cocaine during their mother’s first trimester had higher scores on internalizing and externalizing behavioral problems. Minnes et al. (2010) wanted to compare cocaine-exposed and non-exposed children, ages four through ten. They discovered that the children who were exposed to cocaine in-utero had increased rates of delinquency reported by caregivers, which means that children exposed to cocaine in-utero showed greater externalizing behavior. Another interesting finding of this study by Minnes et al. was that females, not males, exposed to cocaine in-utero showed higher delinquency than those not exposed to cocaine. Overall, these studies suggest that being exposed to cocaine prenatally may affect a child's behavior up to ten years old.

 Other more serious abnormalities have been suggested by Davis et al. (1992). They studied 70 children who were exposed to cocaine in-utero. These children were referred for developmental evaluation to examine abnormalities. Specific effects of cocaine were observed for children who were evaluated to have disorders such as autism. The authors suggested that a high rate of autistic disorders is known to occur specifically from cocaine, and such effects are not observed with exposure to opiates or alcohol.

A systematic review of the effects of prenatal cocaine exposure by Frank et al. (2001) gives some hope. These authors did find, when looking at many studies, an association between in-utero cocaine exposure and decreased attentiveness and emotional expressivity. However, their review suggests that the developmental and behavioral effects may not be as detrimental as suggested by single studies, as overall there does not seem to be consistent results. More studies are needed to put the argument to rest.