Prenatal cocaine exposure: Direct and indirect associations with 21-year-old offspring substance use and behavior problems

• Published in: Drug and alcohol dependence Vol. 195; pp. 121 - 131
• Main Authors: Richardson, Gale A., De Genna, Natacha M., Goldschmidt, Lidush, Larkby, Cynthia, Donovan, John E.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.02.2019; Elsevier Science Ltd
• Subjects: Adolescent; Adolescent Behavior - psychology; Adolescents; Adult; African Americans; Arrests; Behavior problems; Behaviour disordered children; Cannabis; Caregivers; Child; Child development; Childhood; Children; Cocaine; Cocaine - adverse effects; Cocaine-Related Disorders - diagnosis; Cocaine-Related Disorders - epidemiology; Cocaine-Related Disorders - psychology; Cohort analysis; Cohort Studies; Conduct disorder; Correlation analysis; Drug delivery systems; Emotional regulation; Exposure; Female; Follow-Up Studies; Humans; Internalization; Longitudinal Studies; Male; Marijuana; Mathematical models; Mood; Offspring; Postpartum; Postpartum women; Pregnancy; Prenatal care; Prenatal cocaine; Prenatal development; Prenatal experience; Prenatal exposure; Prenatal Exposure Delayed Effects - diagnosis; Prenatal Exposure Delayed Effects - epidemiology; Prenatal Exposure Delayed Effects - psychology; Problem Behavior - psychology; Prospective Studies; Signs and symptoms; Statistical analysis; Statistical models; Substance abuse; Substance use; Substance-Related Disorders - diagnosis; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Target recognition; Young Adult; Young adults; Substance use; Prenatal cocaine; Young adult; Behavior problems
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2018.10.033

•Prospective study of prenatal cocaine exposure (PCE) and adult behavior problems.•Women assessed prenatally, at delivery, 1, 3, 7, 10, 15, and 21 years postpartum.•Direct associations found between PCE and early initiation of marijuana.•PCE directly predicted 21-year emotion regulation, arrests, and Conduct Disorder.•PCE has direct and indirect long-term associations with young adult development. Prenatal cocaine exposure (PCE) has been linked to child/adolescent behavior problems and substance use in several longitudinal cohort studies. It is unclear whether these effects extend into adulthood and influence young adult behavior problems and substance use and, if so, whether they are mediated by childhood and adolescent experiences. These data are from an ongoing longitudinal study of individuals born to women who were recruited early in pregnancy. Trimester-specific data on prenatal drug exposure were obtained. Caregivers and offspring were assessed at delivery and at 1, 3, 7, 10, 15, and 21 years postpartum. This report is from age 21, when 225 offspring (52% females; 54% African American, 46% Caucasian) reported on behavior problems, emotion regulation, and substance use. There were significant direct associations between PCE and early initiation of marijuana, 21-year emotion regulation problems, arrest history, and Conduct Disorder. The relation between PCE and young adult internalizing behavior was mediated by adolescent mood symptoms. The association between PCE and 21-year marijuana use was mediated by early initiation of marijuana use. PCE has both direct and indirect long-term associations with young adult development. Using statistical models that considered the complex interrelationships among PCE and adult outcomes, we demonstrated that the direct effects of PCE on young adult emotion regulation problems, arrest history, and Conduct Disorder are not completely explained by earlier adolescent behavior. Moreover, the analyses suggesting mediated pathways from PCE to young adult problems identify crucial variables to target interventions for exposed children and adolescents.