Attentional Response at 8 Weeks in Prenatally Drug Neurotoxicology and Teratology; under revision Attentional Response at 8 Weeks in Prenatally Drug-Exposed and Preterm Infants By Claire D. Coles, Kim A. Bard Kathleen A. Platzman and Mary Ellen Lynch Human and Behavior Genetics Laboratory Department of Psychiatry and Behavioral Sciences Emory University School of Medicine Atlanta, GA 30306 Abstract COLES. C.D, K.A. BARD, K.A.PLATZMAN, AND M.E.LYNCH. Attentional response at 8 weeks in prenatally drug-exposed and preterm infants. NEUROTOXICOL TERATOL. To evaluate the effect of prenatal/polydrug exposure on infant attention, 105 8-week-old, African-American infants were presented a series of stimuli and heart rate (HR) recorded. Infants were identified postnatally based on mothers’ substance use. Four groups were tested: 1) preterm drug- exposed infants (n=24); 2) full term, drug-exposed (n=32); 3) preterm nonexposed (n=22); 4) full term, nonexposed (n=26). Preterm infants’ ages were corrected. Infants’ baseline HRs were recorded and then stimuli presented in the following order: auditory (rattle), visual (red ring) and social (examiner’s face and voice). There were no HR differences at baseline or in auditory or visual conditions. However, significant differences (F (2,103) =6.54, p<.01) were seen in response to social stimuli. Drug-exposed infants showed an acceleratory HR indicating distress or arousal and control infants showed an deceleratory response indicating focused attention. Hierarchical regression indicated cocaine, but not other drug, use (R 2 =.034, p<.05) and instability in parenting (R 2 =.137, p<.001) accounted for the observed differences. Key Words: Cocaine in Pregnancy; Infant Attention; Heart Rate (HR), Quality of Caregiving Concerns about prenatal cocaine and polydrug exposure have led to examination of many domains of infant outcome, including physical growth, neurodevelopmental status, and emotional/social functioning. At the present time, the most consistent findings indicate that prenatally-exposed children may be at higher risk for significant problems in arousal/attention (26,27,32), behavioral regulation (3,8,28) particularly an increased reactivity (21), and social/ emotional functioning (2,7,9,13) especially as children move into later childhood (4). In infancy, prenatal cocaine exposure appears to influence social responsivity, speed of visual processing, and an interaction between arousal levels and learning. Karmel, Gardner and their colleagues have identified cocaine-related differences in attention and arousal modulation in newborns which persist through four months of age (27,28) and Mayes, Bornstein, Chawarska, and Granger (32) reported that cocaine exposure affected three-month-olds ability to complete file:///D|/WEBSITE%20FOLDER/professionals/attentional.htm (1 of 15)12/21/2004 3:21:59 PM