(WITHDRAWN) Adaptive Functioning in Prenatally Cocaine and Polydrug Exposed Emerging Adults

Objective: A number of prospective studies have associated prenatal cocaine exposure (PCE) with small yet persistent differences in specific cognitive and behavioral domains compared to non-cocaine exposed (NCE) individuals. Little attention, however, has been directed towards examining potential relationships between PCE and adaptive functioning outcomes during emerging adulthood.

Method: Participants were recruited at birth as part of a 21 year longitudinal study examining the effects of prenatal cocaine and polydrug exposure. At the 21 year follow up, 317 (176 female, 141 male; 161 PCE, 156 NCE) predominantly African American (83%) and low SES emerging adults were surveyed regarding their health, sexual behavior, pregnancy, education, employment, income, substance use and probation/incarceration history. Outcomes and their covariates (e.g. caregiver distress, early life home environment, and prenatal exposures to alcohol, tobacco, and marijuana) were selected via bivariate analyses i.e. variables with associations significant at the p < .10 level were considered. Dichotomous outcomes were modeled using logistic regression, continuous multiple regression and count Poisson regression using a backwards elimination approach.

Results: PCE young adults had significantly greater odds (p < .05) of reporting sleep problems (OR=1.44; 95% CI=1.03, 2.02), and lower odds to have obtained a high school degree/GED (OR=0.68; 95% CI=0.49, 0.97) or use a condom (OR=0.74; 95% CI=0.54, 0.99) compared to NCE. PCE was significantly related to lower average monthly income ($794 for PCE vs. $940 for NCE) and to a nonsignificant trend (p < .10) with a 1.31 (95% CI=0.96, 1.79) times greater mean count of health conditions. Among the 72 female participants who had at least 1 pregnancy (39 PCE, 33 NCE), PCE was associated with a 1.27 (95% CI=1.01, 1.61) times greater mean count of pregnancies as well as with greater odds of using tobacco (OR=1.80; 95% CI=1.03, 3.16), marijuana (OR=1.81; 95% CI=1.04, 2.97) or alcohol (OR=1.95; 95% CI=1.02, 3.74) while pregnant. PCE was not significantly associated with BMI, reported number of sexual partners, age of first sex, probation or incarceration or receiving SSI.

Conclusion: In this cohort of predominantly African American, low SES emerging adults, PCE may serve as an indicator of greater risk for negative adaptive functioning outcomes and/or disadvantage. Of particular concern is the relationship between PCE and increased odds of substance use during pregnancy, which suggests transgenerational effects of PCE. Young PCE women may be of special interest for public health intervention given the risks associated with substance use during pregnancy.