Although research methodology in study of the effects of prenatal cocaine exposure has markedly Improved as this complex field has matured, there remain vexing methodological difficulties. Comparing findings across different cohort studies is challenging because of variations in how samples are described or because important sample characteristics are not documented. A few studies of prenatal poly-drug exposure with problems in sample design continue to be published, the implications of sample design for research questions need consideration, and sample attrition is a continuing problem. This paper explains these problems, and suggests some practical solutions. Examples are drawn from the current literature and the authors' experience with the Seattle Cocaine and Pregnancy Study, an early cohort study of cocaine effects.
Get full access to this article
View all access options for this article.
References
1.
AllesandriS.M.BenderskyM.LewisM.1998Cognitive functioning in 8- to 18-month old drug-exposed infants. Developmental Psychology34(3):565–573.
2.
BenderskyM.LewisM.1998Arousal modulation in cocaine-exposed infants. Developmental Psychology34(3):555–564.
3.
BehnkeM.EylerF.D.1993The consequences of prenatal substance abuse for the developing fetus, newborn, and young child. International Journal of the Addictions28(13):1341–1391.
4.
OlsonH. CarmichaelGrantT.M.MartinJ.C.StreissguthA.P.1995A cohort study of prenatal cocaine exposure: Addressing methodological concerns. In Mothers, babies, and cocaine: The role of toxins in development, eds, LewisM.BenderskyM., 129–162. Hillsdale, NJ: Lawrence Erlbaum.
5.
ChasnoffI.J.GriffithD.R.FreierC.MurrayJ.1992Cocaine/polydrug use in pregnancy: Two-year follow-up. Pediatrics89:284–290.
6.
ChasnoffI.J.AnsonA.HatcherR.StensonH.IaukeaK.RandolphL.A.1998Prenatal exposure to cocaine and other drugs. Annals of the New York Academy of Sciences846:314–328.
7.
ChiribogaC.A.1998Neurological correlates of fetal cocaine exposure. Annals of the New York Academy of Sciences846:109–125.
8.
Delaney-BlackV.CovingtonC.TemplinT.AgerJ.MartierS.SokolR.1998Prenatal cocaine exposure and child behavior. Pediatrics102(4/1):945–950.
9.
EylerF.D.BehnkeM.ConlonM.WoodsN.S.WobieK.1998Birth outcome from a prospective, matched study of prenatal crack/cocaine use: I. Interactive and dose effects on health and growth. Pediatrics101(2):229–237.
10.
FrankD.A.AugustynM.ZuckermanB.S.1998Neonatal neurobehavioral and neuroanatomic correlates of prenatal cocaine exposure. Problems of dose and confounding. Annals of the New York Academy of Sciences846:40–50.
11.
GrantT.M.ErnstC.C.StreissguthA.P.PhippsP.GendlerB.1996When case management isn't enough: A model of paraprofessional advocacy for drug- and alcohol-abusing mothers. Journal of Case Management5(1):3–11.
12.
HeffelfingerA.CraftS.ShykenJ.1997Visual attention in children with prenatal cocaine exposure. Journal of the International Neuropsychological Society3:237–245.
13.
HowardJ.1992Subject recruitment and retention issues in longitudinal research involving substance-abusing families: A clinical services context. In Methodological issues in epdemiological, prevention, and treatment research on drug-exposed women and their children, eds, KilbeyM. M.AsgharK., 155–164. Rockville, MD: National Institute on Drug Abuse.
14.
HurtH.BrodskyN.L.BetancourtL.BraitmanL.E.MalmudE.GiannettaJ.1995Cocaine-exposed children: Follow-up through 30 months. Journal of Developmental and Behavioral Pediatrics16:29–35.
15.
HurtH.MalmudE.BetancourtL.BraitmanL.E.BordskyN.L.GiannettaJ.1997Children with in utero cocaine exposure do not differ from control subjects on intelligence testing. Archives of Pediatric and Adolescent Medicine151:1237–1241.
16.
HutchingsD. E.1993aThe puzzle of cocaine's effects following maternal use during pregnancy: Are there reconcilable differences?Neurotoxicology and Teratology15:281–286.
17.
HutchingsD. E.1993bResponse to Commentaries. Neurotoxicology and Teratology15:311–312.
18.
JacobsonJ. L.JacobsonS.W.1996Methodological considerations in behavioral toxicology in infants and children. Developmental Psychology32(3):390–403.
19.
JacobsonS. W.JacobsonJ.L.SokolR.J.MartierS.S.ChiodoL.M.1996New evidence for neurobehavioral effects of in utero cocaine exposure. Journal of Pediatrics129:581–590.
20.
KarmelB.Z.GardnerJ.M.FreedlandR.L.1998Neonatal neurobehavioral assessment and Bayley I and II scores of CNS-injured and cocaine-exposed infants. Annals of the New York Academy of Sciences, 846:391–395.
21.
KorenG.GrahamK.ShearH.EinarsonT.1989Bias against the null hypothesis: The reproductive hazards of cocaine. Lancet2(8677): 1440–1442.
22.
LesterB.M.1998The maternal lifestyles study. Annals of the New York Academy of Sciences846:296–305.
23.
LesterB.M.LaGasseL.SeiferR.1998Cocaine exposure and children: The meaning of subtle effects. Science:228–229.
24.
LesterB.M.LaGasseL.FreierK.BrunnerS.1996Studies of cocaine-exposed human infants. In Behavioral studies of drug-exposed offspring: Methodological issues in human and animal research, eds, WetheringtonC.L.SmeriglioV.L.FinneganL.P., 175–210. Rockville, MD: National Institute on Drug Abuse.
25.
MartinJ. C.BarrH.M.MartinD.C.StreissguthA.P.1996Neonatal neurobehavioral outcome following prenatal exposure to cocaine. Neurotoxicology and Teratology18(6):617–625.
26.
MayesL.C.1996Exposure to cocaine: Behavioral outcomes in preschool and school-aged children. In Behavioral studies of drug-exposed offspring: Methodological issues in human and animal research, eds, WetheringtonC.L.SmeriglioV.L.FinneganL.P., 211–229. Rockville, MD: National Institute on Drug Abuse.
27.
MayesL.C.BornsteinM.H.ChawarskaK.HaynesO.M.GrangerR.H.1996Impaired regulation of arousal in 3-month-old infants exposed prenatally to cocaine and other drugs. Development and Psychopathology8:29–42.
28.
MayesL.C.GrangerR.H.BornsteinM.H.ZuckermanB.1992The problem of prenatal cocaine exposure: A rush to judgment. Journal of the American Medical Association267(3):406–408.
29.
MayesL.M.GrillonC.GrangerR.SchottenfeldR.1998Regulation of arousal and attention in preschool children exposed to cocaine prenatally, Annals of the New York Academy of Sciences846:126–143.
30.
NeuspielD.R.1995The problem of confounding in research of prenatal cocaine effects on behavior and development. In Mothers, babies, and cocaine: The role of toxins in development, eds, LewisM.BenderskyM., 95–110. Hillsdale, NJ: Erlbaum.
31.
RichardsonG.A.1998Prenatal cocaine exposure: A longitudinal study of development. Annals of the New York Academy of Sciences846:144–152.
32.
Rovee-CollierC.1997Uniform editorial policy for reporting SES and race/ethnicity/gender information. Infant Behavior and Development20(1): 1–2.
33.
SingerL.ArendtR.FarkasK.MinnesS.HuangJ.YamashitaT.1997Relationship of prenatal cocaine exposure and maternal postpartum psychological distress to child developmental outcome. Development and Psychopathology9:473–489.
34.
StreissguthA.P.GiuntaC.T.1992Subject recruitment and retention for longitudinal research: Practical considerations for a nonintervention model. In Methodological issues in epdemiological, prevention, and treatment research on drug-exposed women and their children, eds, KilbeyM.M.AsgharK., 137–154. Rockville, MD: National Institute on Drug Abuse.
35.
SwansonM.W.StreissguthA.P.SampsonP.D.OlsonH. Carmichael1999Prenatal cocaine and neuromotor outcome at four months: Effect of duration of exposure. Pregnancy and Health Studies Tech. Rpt 99-01:1–29.
36.
Toth-SadjadiS.1996A prospective study of prenatal cocaine exposure: Language, play, and global cognitive abilities in two-year-olds. Unpublished dissertation. Seattle, WA: University of Washington.
37.
TronickE.Z.FrankD.A.CabralH.MirochnickM.ZuckermanB.1996Late dose-response effects of prenatal cocaine exposure on newborn neurobehavioral performance. Pediatrics98(1):76–83.
