Articles on adoption, foster care, & pediatrics

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Prenatal Drug Exposures

Enough with the Alcohol Already… Other Prenatal Drug Exposures:

Prenatal Drug Research in General

•    Impossible to fully control for genetic (cognitive, mental health), other prenatal exposures, LBW/prematurity, and environmental factors
•    Alcohol may be cofounder in many studies
•    Prenatal drug exposure may make kids more vulnerable to other biomedical and environmental risks


•    BIG association with low birth weight
•    Higher rates of spontaneous abortion, late fetal deaths, prematurity, cleft lip
•    SIDS, ear infections, asthma, etc …
•    Impaired infant state regulation
•    Assoc with lower mental scores/babbling @1yo – cognitive effects minimal by 2yo
•    More externalizing behaviors and inattention/hyperactivity


•    Modest effect on fetal growth (hypoxia)
•    Some subtle infant neurobehavior effects
•    No cognitive /language effects at 1-2yo
•    Memory and verbal outcomes at 4yo possibly impacted by heavy prenatal exposure
•    Some impact on motor development as well

Opiates (heroin, methadone)

•    Low Birthweight (more with heroin)
•    Newborn withdrawal syndrome: jitters/tremor, hypertonia, irritability, high-pitched cry, convulsions, stuffiness, fever, mottling, sweating, loose stools/vomiting, poor feeding
•    Treated with slow opiate taper
•    “Subacute withdrawal” – 3-6mo with irritability, poor state control
•    Subtle late differences in visual-motor and perceptual tasks

Cocaine and Crack

•    Spont abortion, abruption, stillbirths, prematurity, distress (vasoconstriction)
•    Neonatal stokes, focal seizures
•    Urogenital and other malformations
•    Microcephaly
•    Early excitability/irritability in infancy
•    Preschool impulse control issues
•    No cognitive differences on broad scales ...
•    Subtle differences in specific functions (state regulation, lang, attn/impulsivity, visual memory, temperament, aggression)

Speed and Meth

•    Sharp rise in the 90s, especially rural
•    Meth labs – bigtime fire and chemical risks
•    Preterm delivery, abruption
•    LBW, cardiac and cleft defects, smaller subcortical brain volumes
•    Not much data on developmental effects
•    Visual memory, verbal memory, executive function, attention/impulsivity, and long-term spatial memory may be affected

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