Prenatal cocaine use and maternal depression: effects on infant neurobehavior
Amy L Salisbury, Barry M Lester, Ronald Seifer, Linda Lagasse, Charles R Bauer, Seetha Shankaran, Henrietta Bada, Linda Wright, Jing Liu, Ken Poole, Amy L Salisbury, Barry M Lester, Ronald Seifer, Linda Lagasse, Charles R Bauer, Seetha Shankaran, Henrietta Bada, Linda Wright, Jing Liu, Ken Poole
Abstract
Objective: The present study examined the impact of both perinatal maternal depression and cocaine use on infant neurobehavior at 1 month of age in a large, multi-site study.
Methods: Infant neurobehavior was examined in 1053 infants at 1 month of age using the NICU Network Neurobehavioral Scale (NNNS). Mothers were interviewed using The Addiction Severity Index to determine present and past psychiatric history. Four groups were derived from the total sample: 385 prenatally cocaine-exposed infants, 76 whose mothers reported current postpartum depression (DEP/COC) and 309 without current postpartum depression (nonDEP/COC); 668 infants were not exposed to cocaine, 104 whose mothers reported current postpartum depression (DEP/nonCOC), 564 without current postpartum depression (nonDEP/nonCOC). A 2x2 Analysis of Covariance was used with covariates (birthweight, maternal age, SES, nicotine, alcohol, and research site) to examine infant neurobehavior in these four conditions. Secondary analyses were conducted to examine the effects of amount and timing of prenatal cocaine exposure.
Results: DEP group by COC exposure status interactions were significant; there was only a DEP effect in the nonCOC infants. Infants in the nonCOC/DEP group had poorer self-regulation and more stress signs, excitability, and arousal than infants in the other groups.
Conclusions: Postpartum maternal depression has negative effects on infant neurobehavior at 1 month of age. Prenatal cocaine exposure may serve to suppress or buffer the effects of postpartum depression on infant neurobehavior. Maternal mood could explain some of the inconsistencies found in the prenatal cocaine exposure literature.
Conflict of interest statement
Conflicts of Interest: None
Figures
![Figure 1. Amount of cocaine exposure during…](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/1955229/bin/nihms26028f1.jpg)
![Figure 2. NNNS scores for the DEP…](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/1955229/bin/nihms26028f2a.jpg)
Figure 2. NNNS scores for the DEP…
Figure 2. NNNS scores for the DEP and nonDEP group in each COC use group
Figure 2. NNNS scores for the DEP…
Figure 2. NNNS scores for the DEP and nonDEP group in each COC use group
Figure 2. NNNS scores for the DEP…
Figure 2. NNNS scores for the DEP and nonDEP group in each COC use group
- Prenatal substance exposure: neurobiologic organization at 1 month.Conradt E, Sheinkopf SJ, Lester BM, Tronick E, LaGasse LL, Shankaran S, Bada H, Bauer CR, Whitaker TM, Hammond JA; Maternal Lifestyle Study. Conradt E, et al. J Pediatr. 2013 Oct;163(4):989-94.e1. doi: 10.1016/j.jpeds.2013.04.033. Epub 2013 Jun 4. J Pediatr. 2013. PMID: 23743094 Free PMC article.
- Effects of in utero substance exposure on infant neurobehavior.Napiorkowski B, Lester BM, Freier MC, Brunner S, Dietz L, Nadra A, Oh W. Napiorkowski B, et al. Pediatrics. 1996 Jul;98(1):71-5. Pediatrics. 1996. PMID: 8668415
- Smoking during pregnancy and newborn neurobehavior.Law KL, Stroud LR, LaGasse LL, Niaura R, Liu J, Lester BM. Law KL, et al. Pediatrics. 2003 Jun;111(6 Pt 1):1318-23. doi: 10.1542/peds.111.6.1318. Pediatrics. 2003. PMID: 12777547
- Maternal depression and prenatal exposure to methamphetamine: neurodevelopmental findings from the infant development, environment, and lifestyle (ideal) study.Smith LM, Paz MS, LaGasse LL, Derauf C, Newman E, Shah R, Arria A, Huestis MA, Haning W, Strauss A, Della Grotta S, Dansereau LM, Neal C, Lester BM. Smith LM, et al. Depress Anxiety. 2012 Jun;29(6):515-22. doi: 10.1002/da.21956. Epub 2012 May 3. Depress Anxiety. 2012. PMID: 22555777 Free PMC article.
- Prenatal drug exposure: infant and toddler outcomes.Bandstra ES, Morrow CE, Mansoor E, Accornero VH. Bandstra ES, et al. J Addict Dis. 2010 Apr;29(2):245-58. doi: 10.1080/10550881003684871. J Addict Dis. 2010. PMID: 20407980 Review.
- Neonatal Intensive Care Unit Network Neurobehavioral Scale Profiles in Full-Term Infants: Associations with Maternal Adversity, Medical Risk, and Neonatal Outcomes.Parikh AN, Triplett RL, Wu TJ, Arora J, Lukas K, Smyser TA, Miller JP, Luby JL, Rogers CE, Barch DM, Warner BB, Smyser CD. Parikh AN, et al. J Pediatr. 2022 Jul;246:71-79.e3. doi: 10.1016/j.jpeds.2022.04.016. Epub 2022 Apr 14. J Pediatr. 2022. PMID: 35430247
- Fifty Years of Research on Prenatal Substances: Lessons Learned for the Opioid Epidemic.Singer LT, Chambers C, Coles C, Kable J. Singer LT, et al. Advers Resil Sci. 2020 Dec;1(4):223-234. doi: 10.1007/s42844-020-00021-7. Epub 2020 Oct 27. Advers Resil Sci. 2020. PMID: 34316723 Free PMC article.
- The association of prenatal exposure to intensive traffic with early preterm infant neurobehavioral development as reflected by the NICU Network Neurobehavioral Scale (NNNS).Zhang X, Spear E, Gennings C, Curtin PC, Just AC, Bragg JB, Stroustrup A. Zhang X, et al. Environ Res. 2020 Apr;183:109204. doi: 10.1016/j.envres.2020.109204. Epub 2020 Jan 31. Environ Res. 2020. PMID: 32311904 Free PMC article.
- Prenatal antidepressant exposures and gastrointestinal complaints in childhood: A gut-brain axis connection?Salisbury AL, Papandonatos GD, Stroud LR, Smith AK, Brennan PA. Salisbury AL, et al. Dev Psychobiol. 2020 Sep;62(6):816-828. doi: 10.1002/dev.21966. Epub 2020 Mar 13. Dev Psychobiol. 2020. PMID: 32167584 Free PMC article.
- Sociodemographic and medical influences on neurobehavioral patterns in preterm infants: A multi-center study.McGowan EC, Hofheimer JA, O'Shea TM, Carter BS, Helderman J, Neal CR, Pastyrnak S, Smith LM, Soliman A, Dansereau LM, Della Grotta SA, Lester BM. McGowan EC, et al. Early Hum Dev. 2020 Mar;142:104954. doi: 10.1016/j.earlhumdev.2020.104954. Epub 2020 Jan 30. Early Hum Dev. 2020. PMID: 32007912 Free PMC article.
- Multicenter Study
- Adult
- Arousal / physiology
- Attention / physiology
- Cocaine / analysis
- Cocaine / toxicity*
- Depression / complications*
- Depression, Postpartum / psychology
- Female
- Follow-Up Studies
- Humans
- Infant
- Infant Behavior / drug effects*
- Infant Behavior / physiology*
- Infant, Newborn
- Marijuana Smoking / psychology
- Motor Activity / drug effects
- Movement / physiology
- Neonatal Abstinence Syndrome / psychology
- Neuropsychological Tests
- Pregnancy
- Prenatal Exposure Delayed Effects
- Reflex / drug effects
- Smoking / psychology
- Stress, Psychological / psychology
- Substance-Related Disorders / complications
- Surveys and Questionnaires
- Cocaine
- Full Text Sources
- Medical
- Miscellaneous
NCBI Literature Resources
The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.
National Library of Medicine
8600 Rockville Pike
Bethesda, MD 20894
![Figure 2. NNNS scores for the DEP…](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/1955229/bin/nihms26028f2b.jpg)
Figure 2. NNNS scores for the DEP…
Figure 2. NNNS scores for the DEP and nonDEP group in each COC use group
Figure 2. NNNS scores for the DEP…
Figure 2. NNNS scores for the DEP and nonDEP group in each COC use group
- Prenatal substance exposure: neurobiologic organization at 1 month.Conradt E, Sheinkopf SJ, Lester BM, Tronick E, LaGasse LL, Shankaran S, Bada H, Bauer CR, Whitaker TM, Hammond JA; Maternal Lifestyle Study. Conradt E, et al. J Pediatr. 2013 Oct;163(4):989-94.e1. doi: 10.1016/j.jpeds.2013.04.033. Epub 2013 Jun 4. J Pediatr. 2013. PMID: 23743094 Free PMC article.
- Effects of in utero substance exposure on infant neurobehavior.Napiorkowski B, Lester BM, Freier MC, Brunner S, Dietz L, Nadra A, Oh W. Napiorkowski B, et al. Pediatrics. 1996 Jul;98(1):71-5. Pediatrics. 1996. PMID: 8668415
- Smoking during pregnancy and newborn neurobehavior.Law KL, Stroud LR, LaGasse LL, Niaura R, Liu J, Lester BM. Law KL, et al. Pediatrics. 2003 Jun;111(6 Pt 1):1318-23. doi: 10.1542/peds.111.6.1318. Pediatrics. 2003. PMID: 12777547
- Maternal depression and prenatal exposure to methamphetamine: neurodevelopmental findings from the infant development, environment, and lifestyle (ideal) study.Smith LM, Paz MS, LaGasse LL, Derauf C, Newman E, Shah R, Arria A, Huestis MA, Haning W, Strauss A, Della Grotta S, Dansereau LM, Neal C, Lester BM. Smith LM, et al. Depress Anxiety. 2012 Jun;29(6):515-22. doi: 10.1002/da.21956. Epub 2012 May 3. Depress Anxiety. 2012. PMID: 22555777 Free PMC article.
- Prenatal drug exposure: infant and toddler outcomes.Bandstra ES, Morrow CE, Mansoor E, Accornero VH. Bandstra ES, et al. J Addict Dis. 2010 Apr;29(2):245-58. doi: 10.1080/10550881003684871. J Addict Dis. 2010. PMID: 20407980 Review.
- Neonatal Intensive Care Unit Network Neurobehavioral Scale Profiles in Full-Term Infants: Associations with Maternal Adversity, Medical Risk, and Neonatal Outcomes.Parikh AN, Triplett RL, Wu TJ, Arora J, Lukas K, Smyser TA, Miller JP, Luby JL, Rogers CE, Barch DM, Warner BB, Smyser CD. Parikh AN, et al. J Pediatr. 2022 Jul;246:71-79.e3. doi: 10.1016/j.jpeds.2022.04.016. Epub 2022 Apr 14. J Pediatr. 2022. PMID: 35430247
- Fifty Years of Research on Prenatal Substances: Lessons Learned for the Opioid Epidemic.Singer LT, Chambers C, Coles C, Kable J. Singer LT, et al. Advers Resil Sci. 2020 Dec;1(4):223-234. doi: 10.1007/s42844-020-00021-7. Epub 2020 Oct 27. Advers Resil Sci. 2020. PMID: 34316723 Free PMC article.
- The association of prenatal exposure to intensive traffic with early preterm infant neurobehavioral development as reflected by the NICU Network Neurobehavioral Scale (NNNS).Zhang X, Spear E, Gennings C, Curtin PC, Just AC, Bragg JB, Stroustrup A. Zhang X, et al. Environ Res. 2020 Apr;183:109204. doi: 10.1016/j.envres.2020.109204. Epub 2020 Jan 31. Environ Res. 2020. PMID: 32311904 Free PMC article.
- Prenatal antidepressant exposures and gastrointestinal complaints in childhood: A gut-brain axis connection?Salisbury AL, Papandonatos GD, Stroud LR, Smith AK, Brennan PA. Salisbury AL, et al. Dev Psychobiol. 2020 Sep;62(6):816-828. doi: 10.1002/dev.21966. Epub 2020 Mar 13. Dev Psychobiol. 2020. PMID: 32167584 Free PMC article.
- Sociodemographic and medical influences on neurobehavioral patterns in preterm infants: A multi-center study.McGowan EC, Hofheimer JA, O'Shea TM, Carter BS, Helderman J, Neal CR, Pastyrnak S, Smith LM, Soliman A, Dansereau LM, Della Grotta SA, Lester BM. McGowan EC, et al. Early Hum Dev. 2020 Mar;142:104954. doi: 10.1016/j.earlhumdev.2020.104954. Epub 2020 Jan 30. Early Hum Dev. 2020. PMID: 32007912 Free PMC article.
- Multicenter Study
- Adult
- Arousal / physiology
- Attention / physiology
- Cocaine / analysis
- Cocaine / toxicity*
- Depression / complications*
- Depression, Postpartum / psychology
- Female
- Follow-Up Studies
- Humans
- Infant
- Infant Behavior / drug effects*
- Infant Behavior / physiology*
- Infant, Newborn
- Marijuana Smoking / psychology
- Motor Activity / drug effects
- Movement / physiology
- Neonatal Abstinence Syndrome / psychology
- Neuropsychological Tests
- Pregnancy
- Prenatal Exposure Delayed Effects
- Reflex / drug effects
- Smoking / psychology
- Stress, Psychological / psychology
- Substance-Related Disorders / complications
- Surveys and Questionnaires
- Cocaine
- Full Text Sources
- Medical
- Miscellaneous
NCBI Literature Resources
The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.
National Library of Medicine
8600 Rockville Pike
Bethesda, MD 20894
![Figure 2. NNNS scores for the DEP…](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/1955229/bin/nihms26028f2c.jpg)
Figure 2. NNNS scores for the DEP…
Figure 2. NNNS scores for the DEP and nonDEP group in each COC use group
- Prenatal substance exposure: neurobiologic organization at 1 month.Conradt E, Sheinkopf SJ, Lester BM, Tronick E, LaGasse LL, Shankaran S, Bada H, Bauer CR, Whitaker TM, Hammond JA; Maternal Lifestyle Study. Conradt E, et al. J Pediatr. 2013 Oct;163(4):989-94.e1. doi: 10.1016/j.jpeds.2013.04.033. Epub 2013 Jun 4. J Pediatr. 2013. PMID: 23743094 Free PMC article.
- Effects of in utero substance exposure on infant neurobehavior.Napiorkowski B, Lester BM, Freier MC, Brunner S, Dietz L, Nadra A, Oh W. Napiorkowski B, et al. Pediatrics. 1996 Jul;98(1):71-5. Pediatrics. 1996. PMID: 8668415
- Smoking during pregnancy and newborn neurobehavior.Law KL, Stroud LR, LaGasse LL, Niaura R, Liu J, Lester BM. Law KL, et al. Pediatrics. 2003 Jun;111(6 Pt 1):1318-23. doi: 10.1542/peds.111.6.1318. Pediatrics. 2003. PMID: 12777547
- Maternal depression and prenatal exposure to methamphetamine: neurodevelopmental findings from the infant development, environment, and lifestyle (ideal) study.Smith LM, Paz MS, LaGasse LL, Derauf C, Newman E, Shah R, Arria A, Huestis MA, Haning W, Strauss A, Della Grotta S, Dansereau LM, Neal C, Lester BM. Smith LM, et al. Depress Anxiety. 2012 Jun;29(6):515-22. doi: 10.1002/da.21956. Epub 2012 May 3. Depress Anxiety. 2012. PMID: 22555777 Free PMC article.
- Prenatal drug exposure: infant and toddler outcomes.Bandstra ES, Morrow CE, Mansoor E, Accornero VH. Bandstra ES, et al. J Addict Dis. 2010 Apr;29(2):245-58. doi: 10.1080/10550881003684871. J Addict Dis. 2010. PMID: 20407980 Review.
- Neonatal Intensive Care Unit Network Neurobehavioral Scale Profiles in Full-Term Infants: Associations with Maternal Adversity, Medical Risk, and Neonatal Outcomes.Parikh AN, Triplett RL, Wu TJ, Arora J, Lukas K, Smyser TA, Miller JP, Luby JL, Rogers CE, Barch DM, Warner BB, Smyser CD. Parikh AN, et al. J Pediatr. 2022 Jul;246:71-79.e3. doi: 10.1016/j.jpeds.2022.04.016. Epub 2022 Apr 14. J Pediatr. 2022. PMID: 35430247
- Fifty Years of Research on Prenatal Substances: Lessons Learned for the Opioid Epidemic.Singer LT, Chambers C, Coles C, Kable J. Singer LT, et al. Advers Resil Sci. 2020 Dec;1(4):223-234. doi: 10.1007/s42844-020-00021-7. Epub 2020 Oct 27. Advers Resil Sci. 2020. PMID: 34316723 Free PMC article.
- The association of prenatal exposure to intensive traffic with early preterm infant neurobehavioral development as reflected by the NICU Network Neurobehavioral Scale (NNNS).Zhang X, Spear E, Gennings C, Curtin PC, Just AC, Bragg JB, Stroustrup A. Zhang X, et al. Environ Res. 2020 Apr;183:109204. doi: 10.1016/j.envres.2020.109204. Epub 2020 Jan 31. Environ Res. 2020. PMID: 32311904 Free PMC article.
- Prenatal antidepressant exposures and gastrointestinal complaints in childhood: A gut-brain axis connection?Salisbury AL, Papandonatos GD, Stroud LR, Smith AK, Brennan PA. Salisbury AL, et al. Dev Psychobiol. 2020 Sep;62(6):816-828. doi: 10.1002/dev.21966. Epub 2020 Mar 13. Dev Psychobiol. 2020. PMID: 32167584 Free PMC article.
- Sociodemographic and medical influences on neurobehavioral patterns in preterm infants: A multi-center study.McGowan EC, Hofheimer JA, O'Shea TM, Carter BS, Helderman J, Neal CR, Pastyrnak S, Smith LM, Soliman A, Dansereau LM, Della Grotta SA, Lester BM. McGowan EC, et al. Early Hum Dev. 2020 Mar;142:104954. doi: 10.1016/j.earlhumdev.2020.104954. Epub 2020 Jan 30. Early Hum Dev. 2020. PMID: 32007912 Free PMC article.
- Multicenter Study
- Adult
- Arousal / physiology
- Attention / physiology
- Cocaine / analysis
- Cocaine / toxicity*
- Depression / complications*
- Depression, Postpartum / psychology
- Female
- Follow-Up Studies
- Humans
- Infant
- Infant Behavior / drug effects*
- Infant Behavior / physiology*
- Infant, Newborn
- Marijuana Smoking / psychology
- Motor Activity / drug effects
- Movement / physiology
- Neonatal Abstinence Syndrome / psychology
- Neuropsychological Tests
- Pregnancy
- Prenatal Exposure Delayed Effects
- Reflex / drug effects
- Smoking / psychology
- Stress, Psychological / psychology
- Substance-Related Disorders / complications
- Surveys and Questionnaires
- Cocaine
- Full Text Sources
- Medical
- Miscellaneous
![Figure 2. NNNS scores for the DEP…](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/1955229/bin/nihms26028f2d.jpg)
Source: PubMed