Division of Neonatology, Department of Pediatrics, University of Pennsylvania and The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Neurotoxicol Teratol. 2009 Nov-Dec;31(6):334-41. doi: 10.1016/j.ntt.2009.08.002. Epub 2009 Aug 15.
Concern for effects of gestational cocaine exposure (GCE) on human neurocognitive (NC) development is based on effects of cocaine on blood flow to the fetus and impact of cocaine on developing monoaminergic systems. GCE has been shown to affect language, attention and perceptual reasoning skills.
Our objective was to investigate effects of GCE on 7 NC systems, assessed behaviorally in middle school-aged, low socioeconomic status subjects followed prospectively since birth.
55 GCE and 65 non-exposed Control subjects were tested with a battery of 14 tasks adapted from neuroimaging and lesion literature designed to tap 3 frontal systems (Cognitive Control, Working Memory, and Reward Processing) and 4 non-frontal systems (Language, Memory, Spatial Cognition, and Visual Cognition). Using multivariate analysis of covariance, we assessed the relation between NC functioning and GCE status with the following covariates: age at testing; gender; gestational exposure to cigarettes, alcohol and marijuana; foster care placement; caregiver current cocaine use; and two indices of childhood environment.
None of the analyses showed an effect of GCE on NC function. In contrast, child characteristics, including age at testing and childhood environment, were associated with NC function.
In this cohort there is either no effect of GCE on NC function at middle school age, or that effect is less pronounced than the effect of age or childhood environment.
对妊娠期可卡因暴露（GCE）对人类神经认知（NC）发育影响的关注，基于可卡因对胎儿血流的影响以及可卡因对发育中单胺能系统的影响。GCE 已被证明会影响语言、注意力和感知推理能力。
我们的目的是调查 GCE 对 7 个 NC 系统的影响，这些系统在出生后即进行前瞻性随访的社会经济地位较低的中学生中通过行为进行评估。
对 55 名 GCE 组和 65 名非暴露对照组受试者进行了 14 项任务的测试，这些任务改编自神经影像学和损伤文献，旨在评估 3 个额叶系统（认知控制、工作记忆和奖励处理）和 4 个非额叶系统（语言、记忆、空间认知和视觉认知）。使用多元协方差分析，我们评估了 NC 功能与 GCE 状态之间的关系，同时考虑了以下协变量：测试时的年龄；性别；妊娠期接触香烟、酒精和大麻；寄养安置；照顾者当前可卡因使用情况；以及儿童环境的两个指标。
没有分析显示 GCE 对 NC 功能有影响。相比之下，儿童特征，包括测试时的年龄和儿童环境，与 NC 功能相关。
在这个队列中，GCE 对 NC 功能的影响要么不存在，要么不如年龄或儿童环境的影响显著。
