Prenatal Substance Exposure: Associations with Neurodevelopment in Middle Childhood

Am J Perinatol. 2024 May;41(S 01):e1944-e1954. doi: 10.1055/a-2090-5293. Epub 2023 May 10.

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..

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / epidemiology
  • Analgesics, Opioid / adverse effects
  • Child
  • Child Behavior / drug effects
  • Child Development / drug effects
  • Female
  • Humans
  • Intelligence / drug effects
  • Intelligence Tests
  • Longitudinal Studies
  • Male
  • Neurodevelopmental Disorders / epidemiology
  • Neurodevelopmental Disorders / etiology
  • Nicotine* / adverse effects
  • Pregnancy
  • Prenatal Exposure Delayed Effects*
  • Problem Behavior
  • Substance-Related Disorders / epidemiology
  • United States / epidemiology

Substances

  • Nicotine
  • Analgesics, Opioid