To have and to hold: a descriptive study of custody status following prenatal exposure to cocaine † 1370

To have and to hold: a descriptive study of custody status following prenatal exposure to cocaine † 1370

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More than a decade of investigations into the effects of prenatal cocaine exposure has resulted in cautions optimism that the outcomes for infants are not as overwhelmingly negative as first described. Less understood are the factors which explain why some of these children flourish and others flounder. Well-designed research which examines both biological and environmental factors can further this understanding. This paper examines one aspect of environment by describing attributes of biologic mothers and by tracing the path of infant placement throughout the first year of life. Data were collected from women in the rural south enrolled in a prospective, longitudinal study of prenatal cocaine use. Controls (n=154) were matched to users (n=154) on race, SES, parity and prenatal risk. Of the 151 (live) births of exposed children, 43 were in out-of home placement following delivery. By year one, this number had grown to 64. Prenatal interviews indicated that cocaine-using mothers who lost custody had been significantly more depressed, had lower self-esteem, had lower scores on a proxy measure of intelligence(PPVT-R),and were more often incarcerated than users who did not lose custody or non-using controls. These same women reported using significantly more cocaine (p<.004) and alcohol (p<.0001) throughout pregnancy than mothers who did not lose custody; this paralleled their higher infant rate of cocaine-positive toxicology results at birth (54% vs. 33%; p<.001). At 6 months adjusted age, all infants were tested using the Bayley Scales by blinded evaluators. Those being raised in out-of-home placement had significantly lower mean PDI scores (mean=100) than either exposed infants living with their biological mothers (mean=109) or controls (mean=110; p<.005), even after controlling for amount of cocaine and alcohol use. It is not surprising that pregnant women with more risk factors would be at greater risk of infant separation. Lower PPVT scores suggest an added burden of poorer coping and self-representational skills for some women. However, it is surprising that placement into homes anticipated to be more secure and nurturing has not resulted in better developmental outcomes. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Pediatrics, Statistics, University of Florida, Gainesville, FL Kathleen Wobie, Fonda Davis Eyler, Marylou Behnke & Cynthia Wilson Garvan Authors * Kathleen Wobie View author publications You can also search for this author inPubMed Google Scholar * Fonda Davis Eyler View author publications You can also search for this author inPubMed Google Scholar * Marylou Behnke View author publications You can also search for this author inPubMed Google Scholar * Cynthia Wilson Garvan View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Wobie, K., Eyler, F., Behnke, M. _et al._ To Have and To Hold: A Descriptive Study of Custody Status Following Prenatal Exposure to Cocaine † 1370. _Pediatr Res_ 43 (Suppl 4), 234 (1998). https://doi.org/10.1203/00006450-199804001-01391 Download citation * Issue Date: 01 April 1998 * DOI: https://doi.org/10.1203/00006450-199804001-01391 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative

More than a decade of investigations into the effects of prenatal cocaine exposure has resulted in cautions optimism that the outcomes for infants are not as overwhelmingly negative as first


described. Less understood are the factors which explain why some of these children flourish and others flounder. Well-designed research which examines both biological and environmental


factors can further this understanding. This paper examines one aspect of environment by describing attributes of biologic mothers and by tracing the path of infant placement throughout the


first year of life. Data were collected from women in the rural south enrolled in a prospective, longitudinal study of prenatal cocaine use. Controls (n=154) were matched to users (n=154) on


race, SES, parity and prenatal risk. Of the 151 (live) births of exposed children, 43 were in out-of home placement following delivery. By year one, this number had grown to 64. Prenatal


interviews indicated that cocaine-using mothers who lost custody had been significantly more depressed, had lower self-esteem, had lower scores on a proxy measure of intelligence(PPVT-R),and


were more often incarcerated than users who did not lose custody or non-using controls. These same women reported using significantly more cocaine (p<.004) and alcohol (p<.0001)


throughout pregnancy than mothers who did not lose custody; this paralleled their higher infant rate of cocaine-positive toxicology results at birth (54% vs. 33%; p<.001). At 6 months


adjusted age, all infants were tested using the Bayley Scales by blinded evaluators. Those being raised in out-of-home placement had significantly lower mean PDI scores (mean=100) than


either exposed infants living with their biological mothers (mean=109) or controls (mean=110; p<.005), even after controlling for amount of cocaine and alcohol use. It is not surprising


that pregnant women with more risk factors would be at greater risk of infant separation. Lower PPVT scores suggest an added burden of poorer coping and self-representational skills for some


women. However, it is surprising that placement into homes anticipated to be more secure and nurturing has not resulted in better developmental outcomes. AUTHOR INFORMATION AUTHORS AND


AFFILIATIONS * Pediatrics, Statistics, University of Florida, Gainesville, FL Kathleen Wobie, Fonda Davis Eyler, Marylou Behnke & Cynthia Wilson Garvan Authors * Kathleen Wobie View


author publications You can also search for this author inPubMed Google Scholar * Fonda Davis Eyler View author publications You can also search for this author inPubMed Google Scholar *


Marylou Behnke View author publications You can also search for this author inPubMed Google Scholar * Cynthia Wilson Garvan View author publications You can also search for this author


inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Wobie, K., Eyler, F., Behnke, M. _et al._ To Have and To Hold: A Descriptive


Study of Custody Status Following Prenatal Exposure to Cocaine † 1370. _Pediatr Res_ 43 (Suppl 4), 234 (1998). https://doi.org/10.1203/00006450-199804001-01391 Download citation * Issue


Date: 01 April 1998 * DOI: https://doi.org/10.1203/00006450-199804001-01391 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link


Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative