Early adversity strongly mediates relationship between prenatal methamphetamine exposure, behavioral issues
Recent findings published in The Journal of Pediatrics showed that early adversity in life was a previously unaccounted for, but significant confounding variable in the association between prenatal methamphetamine exposure and behavioral problems.
“These findings are consistent with previous work that demonstrated [prenatal methamphetamine exposure (PME)] and early adversity were associated with behavioral and emotional control at age 5 years,” Nwando Eze, MD, MPH, of the department of pediatrics at the David Geffen School of Medicine at UCLA, and colleagues wrote. “Early adversity mediated the relationship between PME and neurobehavioral disinhibition.”
The prevalence of methamphetamine abuse during pregnancy in women seeking treatment tripled from 1994 to 2006, rising to 24% of all pregnant women admitted to federally funded treatment centers, according to the researchers. Eze and colleagues defined early adversity as the sum of multiple binary indicators, including self-reported maternal postnatal substance abuse, an annual household income less than $10,000, reported sexual or physical abuse by a caregiver, a maternal score on the Brief Symptom Inventory, maternal depression above average for the Beck Depression Inventory, quality of living environment below average on the HOME Inventory, community violence above average on the Lifestyle Interview, and social position below average for the Index of Social Position.
The researchers began recruiting for the Infant Development, Environment, and Lifestyle (IDEAL) longitudinal study in 2002. They enrolled 412 mother and infant pairs at four sites and identified participants as methamphetamine-exposed (n = 204) by self-reporting as well as gas chromatography and mass spectrometry analysis of newborn meconium. During 7.5 years of follow-up, Eze and colleagues examined 290 infants, adjusting their model for sex, study site, prenatal tobacco and alcohol and marijuana exposures.
The investigators found that PME was associated with an increased early adversity index score (P < .001) and with increased externalizing, rule-breaking behavior, and aggressive behavior (P < .05). Early adversity also was associated with higher externalizing behavior scores and significantly mediated the relationship between PME and behavioral problems.
“Long-term follow-up is needed for a more complete understanding of the developmental, behavioral, and social outcomes of PME infants,” the researchers wrote. – by Will Offit
Disclosure: The researchers report no relevant financial disclosures.