morphine and Amphetamine-Related-Disorders

Despite extensive evidence of fetal and neonatal risk, a large number of pregnant women are involved in excessive alcohol and drug abuse, such as with cocaine, methamphetamine, opioids, and cannabinoids.

Topics: Adolescent; Adult; Alcohol-Related Disorders; Amphetamine-Related Disorders; Biomarkers; Cannabinoids; Child Welfare; Child, Preschool; Cocaine-Related Disorders; Esters; Fatty Acids; Female; Hair; Humans; Infant; Infant, Newborn; Meconium; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects; Substance Abuse Detection; Substance-Related Disorders

To assess for the increased risk of attention-deficit hyperactivity disorder (ADHD) in young children with prenatal methamphetamine exposure from the multicenter, longitudinal Infant Development, Environment, and Lifestyle (IDEAL) study.. The IDEAL study enrolled 412 mother-infant pairs at 4 sites (Tulsa, OK; Des Moines, IA; Los Angeles, CA; and Honolulu, HI). Methamphetamine-exposed subjects (n = 204) were identified by self-report and/or gas chromatography/mass spectrometry confirmation of amphetamine and metabolites in infant meconium. Matched subjects (n = 208) denied methamphetamine use and had a negative meconium screen. This analysis included a subsample of 301 subjects who were administered the Conners' Kiddie Continuous Performance Test (K-CPT) at 5.5 years of age (153 exposed and 148 comparison). Hierarchical linear models adjusted for covariates tested exposure effects on K-CPT measures. Using the same covariates, logistic regression was used to determine the effect of exposure on the incidence of a positive ADHD confidence index score, defined as greater than 50%.. There were no differences between the groups in omission or commission errors or reaction time for correct trials. However, methamphetamine exposure was associated with subtle differences in other outcomes predictive of ADHD, including increased slope of reaction time across blocks (p < .001), increased variability in reaction time with longer interstimulus intervals (p < .01), and increased likelihood of greater than 50% on the ADHD confidence index (odds ratio, 3.1; 95% confidence interval, 1.2-7.8; p = .02).. Prenatal methamphetamine exposure was associated with subtle differences in K-CPT scores at 5.5 years of age. Even at this relatively young age, these children exhibit indicators of risk for ADHD and warrant monitoring.

Topics: Adult; Amphetamine-Related Disorders; Attention; Attention Deficit Disorder with Hyperactivity; Case-Control Studies; Central Nervous System Stimulants; Child, Preschool; Female; Humans; Linear Models; Logistic Models; Longitudinal Studies; Male; Meconium; Methamphetamine; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects; Psychological Tests