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Estimated Risk of Developing Selected DSM-IV Disorders Among 5-Year-Old Children with Prenatal Cocaine Exposure

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Abstract

We estimated childhood risk of developing selected DSM-IV Disorders, including Attention-Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Separation Anxiety Disorder (SAD), in children with prenatal cocaine exposure (PCE). Children were enrolled prospectively at birth (n = 476) with prenatal drug exposures documented by maternal interview, urine and meconium assays. Study participants included 400 African-American children from the birth cohort, 208 cocaine-exposed (CE) and 192 non-cocaine-exposed (NCE), who attended a 5-year follow-up assessment and whose caregiver completed the Computerized Diagnostic Interview Schedule for Children. Under a generalized linear model (logistic link), Fisher’s exact methods were used to estimate the PCE-associated relative risk (RR) of these disorders. Our results indicated a modest but statistically robust elevation of ADHD risk associated with increasing levels of PCE (p < 0.05). Binary comparison of CE versus NCE children indicated no PCE-associated RR. Estimated cumulative incidence proportions among CE children were 2.9% for ADHD (vs 3.1% NCE); 1.4% for SAD (vs 1.6% NCE); and 4.3% for ODD (vs 6.8% NCE). Our findings suggest evidence of increased risk of ADHD (but not ODD or SAD) in relation to an increasing gradient of PCE during gestation.

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Acknowledgements

The authors are grateful for research assistance and LogXact analyses completed by Dr. Prashanthi Mainampally. This research was supported by the National Institutes of Health National Institute on Drug Abuse (RO1 DA 06556; 1 P50 DA 024584), the NIH Center for Research Resources (5MO1RR 16587) University of Miami General Clinical Research Center, and NIDA Research Training Awards (T32 DA 07292; T32 DA 021129). Additional support for research and services related to this study was provided by the Health Foundation of South Florida and the State of Florida Healthy Start Program.

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Authors and Affiliations

  1. Department of Pediatrics, Miller School of Medicine, University of Miami, Box 016960 (M808), Miami, FL, 33101, USA

    Connie E. Morrow, Veronica H. Accornero, Lihua Xue, Sudha Manjunath & Emmalee S. Bandstra

  2. University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    Jan L. Culbertson

  3. Department of Epidemiology, Michigan State University College of Human Medicine, East Lansing, MI, USA

    James C. Anthony

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  1. Connie E. Morrow
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  2. Veronica H. Accornero
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  3. Lihua Xue
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  4. Sudha Manjunath
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  5. Jan L. Culbertson
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  6. James C. Anthony
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  7. Emmalee S. Bandstra
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Correspondence to Connie E. Morrow.

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Morrow, C.E., Accornero, V.H., Xue, L. et al. Estimated Risk of Developing Selected DSM-IV Disorders Among 5-Year-Old Children with Prenatal Cocaine Exposure. J Child Fam Stud 18, 356–364 (2009). https://doi.org/10.1007/s10826-008-9238-6

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