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Background: Maternal overweight and obesity affect two-thirds of women of childbearing age and may increase the risk of impaired child cognition.Objective: Our objective was to test the hypothesis that high/low gestational weight gain (GWG) and high/low prepregnancy BMI were associated with offspring intelligence quotient (IQ) and executive function at age 10.Methods: Mother-infant dyads (n = 763) enrolled in a birth cohort study were followed from early pregnancy to 10 y postpartum. IQ was assessed by trained examiners with the use of the Stanford Binet Intelligence Scale-4th edition. Executive function was assessed by the number of perseverative errors on the Wisconsin Card Sorting Test and time to complete Part B on the Trail Making Test. Self-reported total GWG was converted to gestational-age-standardized GWG z score. Multivariable linear regression and negative binomial regression were used to estimate independent and joint effects of GWG and BMI on outcomes while adjusting for covariates.Results: At enrollment, the majority of women in the Maternal Health Practices and Child Development cohort were unmarried and unemployed, and more than one-half reported their race as black. The mean ± SD GWG z score was -0.5 ± 1.8, and 27% of women had a pregravid BMI ≥ 25. The median (IQR) number of perseverative errors was 23 (17, 29), the mean ± SD time on Part B was 103 ± 42.6 s, and 44% of children had a low average IQ (≤ 89). Maternal obesity was associated with 3.2 lower IQ points (95% CI: -5.6, -0.8) and a slower time to complete the executive function scale Part B (adjusted β: 12.7 s; 95% CI: 2.8, 23 s) compared with offspring of normal-weight mothers. Offspring of mothers whose GWG was >+1 SD, compared with -1 to +1 SD, performed 15 s slower on the executive function task (95% CI: 1.8, 28 s). There was no association between GWG z score and offspring composite IQ score (adjusted β: -0.32; 95% CI: -0.72, 0.10). Prepregnancy BMI did not modify these associations.Conclusions: Although GWG may be important for executive function, maternal BMI has a stronger relation than GWG to both offspring intelligence and executive function. Our findings contribute to evidence linking maternal obesity to long-term child outcomes. [ABSTRACT FROM AUTHOR]

Abstract: Aims: The aim of this study is to assess the effect of brief motivational enhancement intervention postpartum alcohol use. Design: This study is a single-blinded, randomized controlled effectiveness trial in which pregnant women were assigned to receive usual care or up to 5 face-to-face brief motivational enhancement sessions lasting 10–30minutes each and occurring at study enrollment, 4 and 8weeks after enrollment, 32weeks of gestation, and 6weeks postpartum. Setting: The setting is in a large, urban, obstetrics clinic. Participants: Participants were women who were ≥18years old, <20weeks of gestation, and consumed alcohol during pregnancy. Of 3438 women screened, 330 eligible women were assigned to usual care (n = 165) or intervention (n =165). Due to missing data, we analyzed 125 in the intervention group and 126 in the usual care group. Measurements: The measurements were the proportion of women with any alcohol use and the number of drinks per day, reported via follow-up telephone interviews at 4 and 8weeks after enrollment, 32weeks of gestation, and 6weeks, 6months, and 12months postpartum. Findings: In random effects models adjusted for confounders, the intervention group was less likely to use any alcohol (odds ratio 0.50; 95% confidence interval [CI], 0.23–1.09; P =0.08) and consumed fewer drinks per day (coefficient −0.11; 95% CI −0.23–0.01; P =0.07) than, the usual care group in the postpartum period but these differences were non-significant. Missing data during the prenatal period prevented us from modeling prenatal alcohol use. Conclusions: Brief motivational enhancement intervention delivered in an obstetrical outpatient setting did not conclusively decrease alcohol use during the postpartum period. [Copyright &y& Elsevier]

Abstract: We hypothesized that there would be an association between prenatal marijuana exposure (PME) and delinquency and that the effects of PME on neurocognitive development would mediate this association. Mothers and offspring enrolled in a longitudinal study of the effects of prenatal substance exposure on child development, were interviewed from the fourth prenatal month through 14 years. There were 580 mother/child dyads at the 14-year phase. A standardized protocol assessed psychological, neurocognitive, social, environmental, and demographic characteristics, and substance use at each phase. The Self Report Delinquency scale (Loeber et al., 1998) and the Child Behavior checklist (Achenbach, 1991) delinquency subscale were combined to represent delinquent behavior. First trimester PME was used as a dichotomous variable, daily use versus all other use. Offspring of heavier marijuana users were significantly more likely to report delinquent behavior at age 14. The odds ratio for delinquency among those who were exposed to one or more joints per day during gestation was 1.76 (C.I. 1.05–2.96). PME significantly predicted child depressive symptoms and attention problems at age 10, after controlling for other significant covariates. Child depressive symptoms and attention problems at age 10 significantly predicted delinquency at 14 years. Theassociation between PME and delinquent behavior at 14 years was mediated by depressive symptoms and attention problems in the offspring at 10 years. [ABSTRACT FROM AUTHOR]

Abstract: Studies of the consequences of prenatal marijuana use have reported effects predominantly on the behavioral and cognitive development of the children. Research on other aspects of child neurobehavioral development, such as psychiatric symptomatology, has been limited. This study examines the relations between prenatal marijuana exposure (PME) and child depressive symptoms at 10 years of age. Data are from the 10-year follow-up of 633 mother–child dyads who participated in the Maternal Health Practices and Child Development Project. Maternal prenatal and current substance use, measures of the home environment, demographic status, and psychosocial characteristics were ascertained at prenatal months four and seven, at delivery, and at age 10. At age 10, the children also completed the Children''s Depression Inventory (CDI) [M. Kovacs. The Children''s Depression Inventory, Multi-Health Systems, Inc., North Tonawanda, NY, (1992).], a self-report measure of current depressive symptoms. Multivariate regressions were used to test trimester-specific effects of marijuana and their associations with the CDI total score, while controlling for significant prenatal predictors and significant current covariates of childhood depression. PME in the first and third trimesters predicted significantly increased levels of depressive symptoms. This finding remained significant after controlling for all identified covariates from both the prenatal period and the current phase at age 10. These findings reflect an association with the level of depressive symptoms rather than a diagnosis of a major depressive disorder. Other significant correlates of depressive symptoms in the children included maternal education, maternal tobacco use (prenatal or current), and the child''s composite IQ score. These findings are consistent with recent reports that identify specific areas of the brain and specific brain functions that are associated with PME. [Copyright &y& Elsevier]

Objective: To evaluate whether the risk of DSM-III major depressive disorder (MDD) is uniform across the 6 months after adolescent exposure to a friend's suicide, and to examine potential moderating or mediating processes that may influence the risk of new-onset MDD.Method: One-month incidence rates of MDD were compared between 129 adolescents who were exposed to a friend's suicide between December 1988 and March 1991 and 145 similar-aged, unexposed community controls participating in the Youth Exposed to Suicide study. Clinical, family, and social factors that antedated the exposure were examined as predictors of new-onset MDD within 1 month of the suicide.Results: Exposed adolescents had a markedly increased risk of developing new-onset MDD that was restricted to a narrow period of time, within 1 month after exposure. In contrast, there were no differences in the incidence of MDD between the groups in months 2 to 6. Past history of alcohol abuse increased the risk of exposure to suicide, which subsequently increased the risk of new-onset MDD within 1 month of exposure. Exposed youths who had both a family history of MDD and feelings of accountability for the death were at considerably increased risk of new-onset MDD.Conclusions: For adolescents exposed to a friend's suicide, events surrounding the death interact with family history of MDD to greatly increase the risk for new-onset MDD. [ABSTRACT FROM AUTHOR]

Investigates the impact of prenatal cocaine exposure while controlling for other factors that influence infant outcome. Detailed information about the use of cocaine, crack, alcohol, tobacco, marijuana and other drugs during each trimester of pregnancy; Results suggesting the absence of any significant effect of prenatal cocaine use in infant growth and morphology.

Many studies have examined changes in marijuana use across adolescence, but few have examined factors associated with transitions from adolescence to young adulthood. We examined prenatal exposures to alcohol and marijuana and adolescent risk and protective factors that best distinguished among abstinence, continuity, or cessation of marijuana use from 16 to 22 years. Data were from the Maternal Health Practices and Child Development Project at the prenatal and 16- and 22-year follow-up phases. The offspring were of lower socioeconomic status with an average of 12.8 years of education at 22 years. Participants' frequency and quantity of marijuana use over the past year were used to determine change in use. A discriminant analysis was applied to distinguish among the identified groups. The risk factors considered included prenatal substance exposures and age 16 demographics, behavior, and home environment. Four categories of transitions were defined based on marijuana use from 16 to 22 years: non-users (n = 193), stop/decrease (n = 81), continue at same level/increase (n = 125), and initiation after the 16-year phase (n = 122). The factors that best distinguished among these groups were peers' marijuana use, delinquency, caregivers' financial strain, prenatal exposure to alcohol and marijuana, and race. Prenatal alcohol and marijuana exposure were significantly related to transitions of marijuana use from adolescence to young adulthood, controlling for peers' use, behavior problems, and home environment. While gestational marijuana exposure was associated with early initiation/increasing use, alcohol exposure was related to later initiation. The findings emphasize the long-term effects of prenatal exposure to alcohol and marijuana. • Discriminant analysis identified factors linked to 16–22 years marijuana use. • Adolescent delinquency and peer use were linked to persistent marijuana use. • Caregiver financial strain was also associated with continued marijuana use. • Prenatal marijuana exposure was associated with early initiation of use. • Prenatal alcohol exposure was associated with later initiation of marijuana use. [ABSTRACT FROM AUTHOR]

Aims The goals of this study are to determine if there is (a) a threshold effect for prenatal tobacco exposure (PTE) on adolescent risk for nicotine dependence, and (b) an additive effect of PTE and maternal postnatal nicotine dependence on adolescent risk for nicotine dependence. Methods Pregnant women were recruited in their 4th or 5th gestational month and asked about cigarette use during the first trimester. Mothers reported on third trimester cigarette use at delivery. Sixteen years post-partum, mothers and offspring reported on current levels of cigarette use (N = 784). Nicotine dependence was assessed in both using a modified Fagerström questionnaire. Results Based on the results of a threshold analysis for PTE, four groups were created: threshold PTE only (10 + cigarettes per day), maternal nicotine postnatal dependence with no-low PTE (0– < 10 cigarettes per day), threshold PTE + maternal postnatal nicotine dependence, and a referent group with no-low PTE and no maternal postnatal nicotine dependence. Adolescents in the PTE-only group and the PTE + maternal postnatal nicotine dependence group were significantly more likely to be at risk for nicotine dependence than the offspring from the referent group. However, there was no evidence for an additive effect of maternal postnatal nicotine dependence, and maternal nicotine dependence was not a significant predictor of adolescent risk for nicotine dependence in regression models including prenatal tobacco exposure. Conclusions Bivariate analysis revealed a threshold effect for PTE of 10 cigarettes per day. In multivariate analysis, PTE remained significantly related to risk for offspring nicotine dependence, after controlling for maternal postnatal nicotine dependence and other covariates associated with adolescent cigarette use. [ABSTRACT FROM AUTHOR]

Background: Patterns of smoking vary as a function of age and race. The goals of this study were to identify trajectories of maternal cigarette use over a 17-year span, and to determine if maternal age at first birth and race were associated with smoking trajectories.Methods: Pregnant women (N=690) were recruited at an urban prenatal clinic. The women (13-42years old; 62% African-American, 38% White) were interviewed about cigarette use during pregnancy and 6, 10, 14, and 16years postpartum. Growth mixture modeling (GMM) was used to identify trajectories. Regressions were used to determine if maternal age at first birth and race predicted trajectory class membership.Results: A GMM of maternal cigarette use delineated 5 groups: none/unlikely to use (33%), decreasing likelihood of use (6%), late desistance (5%), increasing likelihood of use (17%), and chronic use (39%). Women who became mothers at a younger age were more likely to be classified as late desisters or increasingly likely to smoke. White mothers were more likely to be chronic smokers. Different smoking trajectories and predictors of trajectories were identified for the African-American and White mothers. Covariates including prenatal substance use, hostility, education, and economic hardship also differentiated smoking trajectories.Conclusions: Both prevention and treatment of smoking should be targeted to specific groups by age of first pregnancy and race. Pregnant smokers should be provided with more information and resources to help them avoid cigarettes during pregnancy and maintain abstinence after pregnancy. [ABSTRACT FROM AUTHOR]

Abstract: We examined the long-term effects of prenatal cigarette smoke exposure (PCSE) on the behavior problems and smoking behavior of 22-year-old offspring. The mothers of these offspring were interviewed about their tobacco and other drug use during pregnancy at the fourth and seventh gestational months, and at delivery. Data on the offspring are from interviews at age 22 (n=608). Behavior problems were measured by the Adult Self-Report (ASR) with the following outcome scales: total behavior problems, externalizing, internalizing, attention, anxiety/depression, withdrawn, thought, intrusive, aggression, somatic and rule breaking behavioral problems. Young adult smoking behavior was measured using self-reported average daily cigarettes, and was validated with urine cotinine. Nicotine dependence was measured with the Fagerström Tobacco and Nicotine Dependence (FTND) scale. Regression analyses tested the relations between trimester-specific PCSE and young adult''s behavioral problems and smoking behavior, adjusting for demographic and maternal psychological characteristics, and other prenatal substance exposures. Exposed young adults had significantly higher scores on the externalizing, internalizing, aggression, and somatic scales of the ASR. These young adults were also more likely to have a history of arrests. Young adults with PCSE also had a higher rate of smoking and nicotine dependence. Our previous findings of the relations between PCSE and aggressive behavior in early childhood and PCSE and smoking behavior in early adolescence extend into young adulthood. [Copyright &y& Elsevier]

This prospective study evaluated the relations between maternal alcohol, tobacco and marijuana use during pregnancy and children''s growth at 6 years. In this cohort of pregnant teenagers and their offspring, mothers were recruited from an urban prenatal clinic between 1990 and 1995, and observed from their fourth prenatal month. At the delivery assessment, there were 413 live-born singletons. At the 6-year visit, 345 children and mothers were evaluated. Prenatal alcohol and marijuana exposure were significantly associated with growth deficits, after controlling statistically for other prenatal substance use, current maternal substance use, current environmental tobacco exposure (ETS) and sociodemographic and growth-related covariates. There was a significant negative association between the second and third trimester alcohol exposure and offspring height. Third trimester alcohol exposure predicted reduced skinfold thickness. Exposure to any prenatal marijuana in the second trimester was significantly associated with shorter stature. First trimester tobacco exposure was associated with increased skinfold thickness among the 6-year-olds. The effects of prenatal alcohol exposure on growth at birth persisted in older children despite a low level of exposure during gestation. Effects of prenatal marijuana exposure on reduced height were not anticipated and occurred only when use was categorized as any/none. These data are consistent with an emerging body of evidence indicating that, by contrast to the growth deficits associated with smoking during pregnancy, which are evident at birth, the shorter stature associated with prenatal alcohol exposure continues to be evident during childhood. [Copyright &y& Elsevier]

Abstract Studies have shown that prenatal alcohol exposure (PAE) is related to drinking problems during adulthood, but the level of prenatal exposure associated with young adults' quantity and frequency of alcohol use and drinking problems has not yet been established. The relation between PAE and offspring levels of alcohol use and alcohol abuse/dependency was examined in 608 22-year-olds. Mothers were recruited in early pregnancy and maternal alcohol use data were collected for each trimester of pregnancy. The offspring were assessed at multiple phases from birth to young adulthood. The average daily volume of drinking was calculated based on a self-report questionnaire developed by the Maternal Health Practices and Child Development Project and alcohol abuse/dependence was assessed using the Diagnostic Interview Schedule-IV. Exposure to one or more drinks/day during the first trimester of pregnancy was significantly related to increased levels of drinking at 22 years of age, controlling for other predictors of alcohol use. PAE was also related to two or more symptoms of Alcohol Use Disorder, but not to a full diagnosis of young adult alcohol abuse/dependence. These results indicate that individuals exposed to as little as one drink per day during gestation are at risk of higher levels of drinking and more problems with alcohol by age 22. Highlights • A longitudinal study of prenatal alcohol exposure was used to investigate influences on offspring alcohol use at 22 years. • Prenatal alcohol exposure was significantly related to increased levels of drinking at 22 years of age. • Prenatal alcohol exposure was significantly related to two or more symptoms of alcohol abuse/dependence. • Prenatal alcohol exposure was not related to full diagnosis of young adult alcohol abuse/dependence measured by DIS-IV. [ABSTRACT FROM AUTHOR]

Abstract Co-use of cannabis and tobacco is increasingly common among women and is associated with tobacco and cannabis dependence and poorer cessation outcomes. However, no study has examined maternal patterns of co-use over time, or the impact of maternal co-use on co-use and drug problems in adult offspring. Pregnant women (M age = 23, range = 18–42; 52% African American, 48% White) were asked about substance use during each trimester of pregnancy, and at 8 and 18 months, 3, 6, 10, 14, 16, and 22 years postpartum. We examined patterns of any maternal cigarette and cannabis use during pregnancy and the postpartum years. As young adults (M age = 22.8 years, range = 21–26), 603 offspring completed the Diagnostic Interview Schedule (DIS). Growth mixture modeling (GMM) was used to identify four maternal trajectories through 16 years postpartum: (1) no co-use (66%), (2) decreasing co-use (16%), (3) postpartum-only co-use (11%), and (4) chronic co-use (7%). Offspring whose mothers were in the decreasing co-use group (co-users primarily during prenatal and preschool periods) were more likely to be co-users than the offspring of non-co-users. Offspring whose mothers were chronic co-users of cigarettes and cannabis were more than twice as likely to have a drug use disorder than young adults whose mothers were not co-users. The results of this study highlight the heterogeneity in maternal co-use of tobacco and cannabis over time, with some women quitting during pregnancy but resuming co-use in the postpartum, and other women co-using during pregnancy but desisting co-use over time. Maternal trajectories of co-use were associated with inter-generational transfer of risk for substance use and dependence in adult offspring. Highlights • There are distinct trajectories of maternal co-use of cigarettes and cannabis. • Maternal patterns of co-use predict substance use in young adult offspring. • Offspring of decreasing co-users (with prenatal exposure) more likely to co-use. • Offspring of chronic co-users more likely to have drug use disorder by age 22. [ABSTRACT FROM AUTHOR]

We investigated the associations among gestational factors including prenatal marijuana exposure (PME), child behavior at age 3, early age of onset of marijuana use (EAOM, < 15 years), and adult roles at 22 years. Participants were drawn from the Maternal Health Practices and Child Development (MHPCD) Project, a longitudinal study of prenatal substance exposure in offspring who have been studied for over 22 years since the prenatal phase. Data from the prenatal, birth, 3-, and 22-year phases (N = 608) were used in the present study. Age of onset of offspring substance use was determined based on data from the 14-, 16-, and 22-year phases. The subjects were of lower socioeconomic status, 43% were Caucasian and the remaining were African-American, and 48% were males. Early childhood behavior was significantly (p < 0.05) related to EAOM after controlling for PME, birth and childhood environmental risk factors, and Conduct Disorder. EAOM was significantly associated with negative adult roles including increased risk of being arrested (p < 0.001), lower educational attainment (p < 0.001), having a child without being married (p < 0.05), and unemployment at 22 years (p < 0.001). The correlations between PME and negative adult roles and between early childhood behavior and negative adult roles were also statistically significant. Pathway analysis demonstrated that EAOM significantly mediated the associations between PME and fulfillment of adult roles and between early childhood behavior and adult roles. There are a number of intervention points that could be targeted that would have a long-term impact on lowering the probability of EAOM and less success in adult roles. [ABSTRACT FROM AUTHOR]

Background Earlier studies reported an association between prenatal marijuana exposure (PME) and cognitive and behavioral problems in the offspring. A recent publication demonstrated the relation between PME and offspring marijuana use at age 22. There are no reports of the association between PME and Cannabis Use Disorder (CUD) at 22 years, the age when use of marijuana and CUD peak. Methods Subjects are from the Maternal Health Practices and Child Development Study, a longitudinal study of PME and other exposures during pregnancy. The cohort of mothers and their offspring has been followed since the fourth prenatal month through 22 years of age. A path analysis was conducted on 590 mother-child pairs, representing 77% of the birth cohort, to examine potential pathways from PME to CUD in offspring at 22 years of age. Results There is no direct effect of PME on CUD. There are, however, two indirect pathways from PME to CUD. In the first, the pathway from PME to CUD goes through offspring early age of marijuana onset. In the second, offspring depression at age 10 and early age of marijuana onset predict CUD. Conclusions Although there is no direct effect of PME on CUD, there are significant indirect pathways from PME to CUD that affect the rate of CUD in the population. Thus, PME, offspring depression, and an early age of marijuana initiation, are significant points for intervention. As marijuana is legalized in more states, the rates of marijuana use will increase significantly, including during pregnancy, and the consequences of the association between PME and CUD will become even more significant from a public health perspective. [ABSTRACT FROM AUTHOR]

We examined direct and indirect pathways between adverse environmental exposures during gestation and childhood and drinking in mid-adolescence. Mothers and their offspring ( n = 917 mother/child dyads) were followed prospectively from second trimester to a 16-year follow-up assessment. Interim assessments occurred at delivery, 6, 10, and 14 years. Adverse environmental factors included gestational exposures to alcohol, tobacco, and marijuana, exposures to childhood maltreatment and violence, maternal psychological symptoms, parenting practices, economic and home environments, and demographic characteristics of the mother and child. Indirect effects of early child behavioral characteristics including externalizing, internalizing activity, attention, and impulsivity were also examined. Polytomous logistic regression analyses were used to evaluate direct effects of adverse environmental exposures with level of adolescent drinking. Structural equation modeling (SEM) was applied to simultaneously estimate the relation between early adversity variables, childhood characteristics, and drinking level at age 16 while controlling for significant covariates. Level of drinking among the adolescent offspring was directly predicted by prenatal exposure to alcohol, less parental strictness, and exposures to maltreatment and violence during childhood. Whites and offspring with older mothers were more likely to drink at higher levels. There was a significant indirect effect between childhood exposure to violence and adolescent drinking via childhood externalizing behavior problems. All other hypothesized indirect pathways were not significant. Thus most of the early adversity measures directly predicted adolescent drinking and did not operate via childhood behavioral dysregulation characteristics. These results highlight the importance of adverse environmental exposures on pathways to adolescent drinking. [ABSTRACT FROM AUTHOR]

The associations between prenatal cocaine exposure (PCE) and adolescent behavior, cognitive development, and physical growth were examined in 219 15-year-olds who have participated in a longitudinal study since their fourth gestational month. During the first trimester, 42% of the women used cocaine, with use declining across pregnancy. At the 15-year follow-up, the caregivers were, on average, 43 years old, had 13 years of education, and 50% were African American. First trimester PCE was not associated with global cognitive development or with measures of learning and memory. First trimester PCE was significantly related to adolescent-reported delinquent behavior, poorer problem solving and abstract reasoning, and reduced weight, height, and head circumference at 15 years. These results were significant after other factors that affect these domains were controlled in regression analyses. In addition, exposure to violence partially mediated the effect of PCE on delinquent behavior. These adolescent domains are important because they are predictors of poorer adult functioning. [ABSTRACT FROM AUTHOR]

Background Studies have reported effects of prenatal marijuana exposure (PME) on cognitive and behavioral outcomes. An earlier publication from this study found that PME predicted early onset of marijuana use and frequency of marijuana use at age 14. No study has reported the effects of PME on marijuana use in young adulthood. This is a developmental period when substance use peaks, and by which, initiation of substance use has largely occurred. Methods Subjects were from a longitudinal cohort. Women were interviewed initially in their fourth prenatal month and women and their offspring were followed through 22 years. Significant covariates of offspring marijuana use at 22 years were identified and controlled for using ordinal logistic regression. Results PME predicted marijuana use in the offspring at 22 years after controlling for significant covariates. Prenatal alcohol exposure, offspring race, gender, and age were also significant predictors, but family history of substance abuse or disorder, and sociodemographic and psychological characteristics of the mother and offspring were not. This association was not moderated by gender or race. Conclusions PME is associated with subsequent marijuana use in young adulthood after considering the effects of other significant factors. These findings have important implications for public health given the recent trend toward legitimization of marijuana use. [ABSTRACT FROM AUTHOR]

Abstract: We examined physical growth and behavioral outcomes in 226 10-year-old children who were participants in a longitudinal study of prenatal cocaine exposure (PCE), while controlling for other factors that affect development. During the first trimester, 42% of the women used cocaine, with use declining across pregnancy. At the 10-year follow-up, the caregivers were 37years old, had 12.8years of education, and 50% were African American. First trimester cocaine exposure predicted decreased weight, height, and head circumference at 10years. First trimester cocaine use also predicted maternal ratings of less sociability on the EAS Temperament Survey and more withdrawn behavior problems on the Child Behavior Checklist, more anxious/depressed behaviors on the Teacher Report Form, and more self-reported depressive symptoms on the Children's Depression Inventory. In addition, exposure to violence mediated the effect of PCE on child and teacher reports of depressive symptoms, but not of maternal reports of sociability and withdrawn behaviors. These behaviors may be precursors of later psychiatric problems. [Copyright &y& Elsevier]

Introduction: The goals of this study were to model maternal patterns of cannabis use from one year pre-pregnancy to 16 years postpartum and to determine if different patterns of maternal cannabis use predicted offspring substance use at age 22.Methods: Women were recruited from a prenatal clinic between 1982 and 1984. Maternal cannabis use was assessed by trained interviewers twice during pregnancy, at delivery, 8 and 18 months, 3, 6, 10, 14, and 16 years postpartum. At age 22, substance use and dependence were measured in offspring. Growth mixture models of maternal cannabis use were calculated and adult offspring substance use outcomes were regressed onto maternal cannabis trajectory classes (n = 551).Results: There were five distinct patterns of maternal cannabis use. Offspring of mothers who were chronic cannabis users were more likely to use cannabis (p < 0.001) and develop CUD (p < 0.05) than offspring whose mothers did not use cannabis. Offspring of chronic cannabis users were also more likely to be nicotine dependent by age 22 than offspring whose mothers did not use cannabis (p < 0.01) and than offspring whose mothers were decreasingly likely to use over time (p < 0.01).Conclusions: Integrated variable- and person-centered analyses revealed long-term and meaningful patterns of cannabis use and desistance. Chronic maternal cannabis use is a risk factor for regular and dependent cannabis use and for dependent tobacco use among young adult offspring. These findings have implications for maternal-child health given the increasing prevalence of cannabis use among women. [ABSTRACT FROM AUTHOR]

The article presents a study on the relationship between prenatal cocaine exposure (PCE) and adolescent drug use. Information is also provided on the impact of PCE on behavior and mood changes in children by the age of 10. Results of interviews with adolescents concerning their use of alcohol, marijuana, and tobacco are also included, citing PCE as well as the influence of factors such as violence, childhood maltreatment, and familial factors as causing such exposure.

Abstract: The relation between prenatal marijuana exposure (PME) and school achievement was evaluated in a sample of 524 14-year-olds. Women were recruited during pregnancy and assessed, along with their offspring, at multiple phases from infancy to early adulthood. The sample represents a low-income population. Half of the adolescents are male and 55% are African American. School achievement was assessed with the Wechsler Individual Achievement Test (WIAT) Screener (Psychological Corporation, 1992). A significant negative relation was found between PME and 14-year WIAT composite and reading scores. The deficit in school achievement was mediated by the effects of PME on intelligence test performance at age 6, attention problems and depression symptoms at age 10, and early initiation of marijuana use. These findings suggest that the effects of PME on adolescent achievement are mediated by the earlier negative effects of PME on child characteristics. The negative impact of these characteristics on adolescent achievement may presage later problems in early adulthood. [Copyright &y& Elsevier]

The article presents a study which examines the association between prenatal alcohol exposure and the rate of conduct disorder in exposed and unexposed adolescents in Pittsburgh, Pennsylvania. Data from a longitudinal study of prenatal substance exposures were analyzed. Findings of the study revealed that prenatal alcohol use in the first trimester is significantly associated with an increased rate of conduct disorder in the adolescents.

Abstract: In this prospective study, adolescent mothers (mean age=16; range=12–18; 70% African-American) were interviewed about their tobacco use during pregnancy. When their children were ten, mothers reported on their child''s behavior and the children completed a neuropsychological battery. We examined the association between prenatal cigarette smoke exposure (PCSE) and offspring neurobehavioral outcomes on data from the 10-year phase (n =330). Multivariate regression analyses were conducted to test if PCSE predicted neurobehavioral outcomes, adjusting for demographic characteristics, maternal psychological characteristics, prenatal exposure to other substances, and exposure to environmental tobacco smoke. Independent effects of PCSE were found. Exposed offspring had more delinquent, aggressive, and externalizing behaviors (CBCL). They were more active (Routh, EAS, and SNAP) and impulsive (SNAP) and had more problems with peers (SNAP). On the Stroop test, deficits were observed on the more complex interference task that requires both selective attention and response inhibition. The significant effects of PCSE on neurobehavioral outcomes were found for exposure to as few as 10 cigarettes per day. Most effects were found from first trimester PCSE exposure. These results are consistent with results from an earlier assessment when the children were age 6, demonstrating that the effects of prenatal tobacco exposure can be identified early and are consistent through middle childhood. [Copyright &y& Elsevier]

Abstract: Deficits in motor control are often reported in children with prenatal alcohol exposure (PAE). Less is known about the effects of prenatal tobacco exposure (PTE) and prenatal marijuana exposure (PME) on motor coordination, and previous studies have not considered whether PTE, PAE, and PME interact to affect motor control. This study investigated the effects of PTE, PAE, and PME as well as current drug use on speed of processing, visual–motor coordination, and interhemispheric transfer in 16-year-old adolescents. Data were collected as part of the Maternal Health Practices and Child Development Project. Adolescents (age 16, n=320) participating in a longitudinal study of the effects of prenatal substance exposure on developmental outcomes were evaluated in this study. The computerized Bimanual Coordination Test (BCT) was used to assess each domain of function. Other important variables, such as demographics, home environment, and psychological characteristics of the mother and adolescent were also considered in the analyses. There were significant and independent effects of PTE, PAE, and PME on processing speed and interhemispheric transfer of information. PTE and PME were associated with deficits in visual–motor coordination. There were no interactions between PAE, PTE, and PME. Current tobacco use predicted deficits in speed of processing. Current alcohol and marijuana use by the offspring were not associated with any measures of performance on the BCT. [Copyright &y& Elsevier]

Abstract: This study characterized the extent and patterns of self-reported drug use among aging adults with and without HIV, assessed differences in patterns by HIV status, and examined pattern correlates. Data derived from 6351 HIV-infected and uninfected adults enrolled in an eight-site matched cohort, the Veterans Aging Cohort Study (VACS). Using clinical variables from electronic medical records and socio-demographics, drug use consequences, and frequency of drug use from baseline surveys, we performed latent class analyses (LCA) stratified by HIV status and adjusted for clinical and socio-demographic covariates. Participants were, on average, age 50 (range 22–86), primarily male (95%) and African-American (64%). Five distinct patterns emerged: non-users, past primarily marijuana users, past multidrug users, current high consequence multidrug users, and current low consequence primarily marijuana users. HIV status strongly influenced class membership. Non-users were most prevalent among HIV uninfected (36.4%) and current high consequence multidrug users (25.5%) were most prevalent among HIV-infected. While problems of obesity marked those not currently using drugs, current users experienced higher prevalences of medical or mental health disorders. Multimorbidity was highest among past and current multidrug users. HIV-infected participants were more likely than HIV-uninfected participants to be current low consequence primarily marijuana users. In this sample, active drug use and abuse were common. HIV-infected and uninfected Veterans differed on extent and patterns of drug use and on important characteristics within identified classes. Findings have the potential to inform screening and intervention efforts in aging drug users with and without HIV. [Copyright &y& Elsevier]

The article reports on the study conducted which examines the effect of prenatal exposure to marijuana on the mental development of children. The inquiry was done through interviewing women ranging from light to moderate users of marijuana in their fourth to seventh months of pregnancy, while the intelligence evaluation on their children was done through the use of Stanford-Binet Intelligence Scale. Through the use of multiple regression method, it was found out that there was a relevant nonlinear relationship between exposure to marijuana and the intelligence of children. It was revealed that intense use of marijuana during the second trimester of pregnancy reduces composite, short-term memory and quantitative scores in children.

Objective: To identify factors that predict or are correlated with symptoms of depression and anxiety in 10-year-olds.Method: Women and their offspring were followed from the fourth prenatal month through 10 years. There were 636 mother-child pairs at 10 years, a follow-up rate of 83% of the birth cohort. Cognitive, psychological, sociodemographic, and environmental factors were measured at each phase. High depression and anxiety were defined as having a number of symptoms >1 SD above the mean for each measure. These measures were combined to represent high depression and/or anxiety (D/A) at 10 years of age.Results: Predictors from the prenatal period of D/A at 10 years were more maternal depression symptoms, African American race, less social support, greater household density, and prenatal marijuana exposure. From 18 months through 6 years, lower child IQ, child injuries at age 3, and attention problems predicted symptoms of D/A at age 10. Across all study phases, lower child IQ, household density during pregnancy, attention problems, early childhood injuries, and prenatal marijuana exposure predicted D/A. Maternal psychological and sociodemographic factors were not significant in the final model.Conclusions: Factors from gestation and early childhood predict high symptom levels of depression and anxiety at age 10. When gestational exposure, early environmental factors, and child characteristics were considered, maternal depression and socioeconomic status were not significantly associated with early onset D/A. Marijuana exposure during gestation marginally predicted depression/anxiety at age 10. [ABSTRACT FROM AUTHOR]

Abstract: Recent reports indicate a relation between prenatal tobacco exposure (PTE) and offspring smoking. Many of these reports have been retrospective or have not included important variables such as other prenatal substance exposures, maternal and child psycho-social characteristics, mother''s current smoking, and friends'' smoking. No prior study has examined the timing of PTE. In this prospective study of a birth cohort of 567 14-year-olds, we examined the relation between trimester-specific PTE, offspring smoking, and other correlates of adolescent smoking. Average age of the adolescents was 14.8 years (range: 13.9–16.6 years), 51% were female, 54% were African-American. Data on maternal tobacco and other substance use were collected both prenatally and postnatally, 51% of the mothers were prenatal smokers and 53% smoked when their children were 14 years. PTE in the third trimester significantly predicted offspring smoking (ever/never, smoking level, age of onset) when demographic and other prenatal substances were included in the analyses. PTE remained a significant predictor of the level of adolescent smoking when maternal and child psychological characteristics were added to the model. When more proximal measures of the child''s smoking were included in the model, including mother''s current smoking and friends'' smoking, PTE was no longer significant. Significant predictors of adolescent smoking at age 14 were female gender, Caucasian race, child externalizing behavior, maternal anxiety, and child depressive symptoms. Although direct effects of PTE on offspring smoking behavior have previously been reported from this study and by others, by early-adolescence, this association is not significant after controlling for the more proximal covariates of adolescent smoking such as mother''s current smoking and peer smoking. [Copyright &y& Elsevier]

The effects of prenatal marijuana and alcohol exposure on school achievement at 10 years of age were examined. Women were interviewed about their substance use at the end of each trimester of pregnancy, at 8 and 18 months, and at 3, 6, 10, 14, and 16 years. The women were of lower socioeconomic status, high-school-educated, and light-to-moderate users of marijuana and alcohol. The sample was equally divided between Caucasian and African–American women. At the 10-year follow-up, the effects of prenatal exposure to marijuana or alcohol on the academic performance of 606 children were assessed. Exposure to one or more marijuana joints per day during the first trimester predicted deficits in Wide Range Achievement Test—Revised (WRAT—R) reading and spelling scores and a lower rating on the teachers'' evaluations of the children''s performance. This relation was mediated by the effects of first-trimester marijuana exposure on the children''s depression and anxiety symptoms. Second-trimester marijuana use was significantly associated with reading comprehension and underachievement. Exposure to alcohol during the first and second trimesters of pregnancy predicted poorer teachers'' ratings of overall school performance. Second-trimester binge drinking predicted lower reading scores. There was no interaction between prenatal marijuana and alcohol exposure. Each was an independent predictor of academic performance. [Copyright &y& Elsevier]

This report from a longitudinal study of the effects of prenatal alcohol and marijuana exposure investigates whether these drugs affect neuropsychological development at 10 years of age. Women were recruited from a medical assistance prenatal clinic and interviewed about their substance use at the end of each trimester of pregnancy, at 8 and 18 months, and at 3, 6, 10, 14, and 16 years. Half of the women were African American, and half were Caucasian. The women were generally from lower socioeconomic status families and had obtained high school degrees. At the 10-year follow-up, 593 children completed a neuropsychological battery, which focused on problem solving, learning and memory, mental flexibility, psychomotor speed, attention, and impulsivity. Prenatal alcohol use was found to have a significant negative impact on learning and memory skills, as measured by the WRAML. Prenatal marijuana exposure also had an effect on learning and memory, as well as on impulsivity, as measured by a continuous performance task. The effects of prenatal alcohol and marijuana exposure persisted when other predictors of learning and memory were controlled. We continue to follow these offspring into the adolescent years when further neuropsychological deficits may become evident. [Copyright &y& Elsevier]

Introduction: Daily combustible cigarette use is common among cannabis users, and dual use of cigarettes and cannabis is associated with detrimental outcomes. This study addresses gaps in the literature by examining data from the prenatal and adolescent phases of a prospective, longitudinal study to predict adult daily dual use.Methods: Young adult offspring (M age = 22.8 years, 53% female) from a prenatal cohort reported on combustible cigarette and cannabis use (N = 500, 58% Black, 42% White). Pathways to daily dual use were modeled using variables from the gestational and adolescent phases of the study including prenatal tobacco, alcohol, and cannabis exposures; ages at initiation of cigarettes and cannabis; and adolescent learning/memory, impulsivity, and behavior problems.Results: Prenatal cannabis and tobacco use were not directly linked to adult daily dual use of cannabis and tobacco. However, structural equation modeling revealed three significant indirect pathways from prenatal cigarette and cannabis exposures to adult daily dual use of cigarettes and cannabis via early cigarette initiation, early cannabis initiation, and adolescent behavior problems.Conclusions: This study identified pathways from prenatal cannabis and tobacco exposure to adult daily dual use, in addition to clarifying adolescent outcomes that may be part of the pathways. In a climate of growing acceptance of cannabis use and increasing legalization of recreational use, these findings serve as a warning that early exposure to cannabis may have an important role in shaping long-term dual use of tobacco and cannabis. [ABSTRACT FROM AUTHOR]

More Americans are using marijuana than in previous decades but there are concerns over its long-term impact on cognitive functioning, especially memory. The literature on marijuana use and cognitive functioning is mixed, with some studies showing recovery of functioning upon abstinence from the drug and others showing long-term effects that persist. The latter seems especially true for individuals who initiate marijuana at a younger age and engage in more chronic patterns of use. The goal of the current study is to use prospectively collected data on young adults from a prenatal cohort to determine if there is an effect of early and/or current marijuana use on young adult memory, controlling for prenatal exposure to marijuana use, childhood memory deficits, and other significant covariates of memory functioning. At the 22-year follow-up phase of the Maternal Health Practices and Child Development (MHPCD) study, 524 young adults (58% Black, 42% White, 52% female) completed the Wechsler Memory Scale-III. Multiple regression analyses and structural equation modeling were used to determine the effect of marijuana exposure during gestation, early adolescence, and young adulthood on young adult memory function. Results indicated that initiating marijuana use before age 15 placed young adults at greater risk of memory deficits, even after controlling for childhood memory and current marijuana use. First trimester marijuana exposure also indirectly predicted young adult memory function via childhood memory deficits and early initiation of marijuana. These findings highlight the risk of prenatal marijuana exposure and early initiation of marijuana for long-term memory function in adulthood. • Longitudinal study of the impact of marijuana on adult memory function. • Prenatal, early onset, and young adult marijuana use were examined. • Early onset marijuana use predicted increased memory deficits in young adulthood. • First trimester marijuana exposure indirectly predicted young adult memory. • Prenatal, adolescent, and adult marijuana exposure are each associated with memory. [ABSTRACT FROM AUTHOR]