Federal grant launches next phase of 20-year study: How prenatal cocaine exposure affects young adults

Case Western Reserve University researchers have tracked their development since birth

Since 1994, researchers at Case Western Reserve University’s Jack, Joseph and Morton Mandel School of Applied Social Sciences have studied children prenatally exposed to cocaine and their mothers to track their development from birth through adolescence. With a four-year, $2.5 million grant from the National Institute on Drug Abuse of the National Institutes of Health (NIH), those children—now young adults—enter the next phase of the long-term study, called Project Newborn (award number R01 DA007957). Now, researchers from the social work school are examining how the effects of early cocaine exposure—which, for many, resulted in drug use and anti-social behavior as adolescents—may have shifted as they’ve entered their 20s. “In this new study, we will have an opportunity to understand the challenges Project Newborn participants have as adults,” said Sonia Minnes, associate professor of social work, who is leading the study, “The Effects of Prenatal Cocaine Exposure in Emerging Adulthood.” Researchers will revisit 359 participants from the original Project Newborn study. Of that total, 183 were prenatally exposed to cocaine, while 176 were not. The two groups have been compared at various stages since the study began to measure the possible effects of pre-birth cocaine exposure on child development. The new study will focus on three areas: substance abuse, anti-social behaviors and adaptive functioning (educational attainment, vocational status and quality of relationships). Researchers will also examine the long-term effects of elevated levels of lead, iron deficiencies and living with non-relatives. Researchers hope to use what they learn to develop interventions timed to when prenatally drug-exposed children may be most susceptible to using drugs, getting involved in criminal activities and dropping out of school.

Project Newborn’s history

The new phase builds on 20 years of research initiated by Lynn T. Singer, Case Western Reserve’s deputy provost and vice president for academic affairs and a professor of pediatrics at the School of Medicine. She launched the project in 1994 in response to national concerns for babies being born to drug-addicted mothers. The children—one group exposed prenatally to cocaine and another “control” group that was not—were examined several times in the first two years and again at ages 4, 6, 9, 10, 11, 12, 15 and 17. The researchers found that children in foster and adoptive care are faring better in language and cognitive development than those living with their birth mothers who used cocaine. But all tend to have similar behavior issues. Minnes said prenatal cocaine exposure seems to result in subtle neurological deficits. “Even as newborns, we saw subtle attention issues,” she said. Researchers also noticed that the children, as toddlers, struggled with visual recognition—remembering what they saw. As they grew older, cocaine-exposed children had behavior problems at home and at school. They also reported more substance use and were less able to plan ahead, organize and monitor their thinking and behavior. “School can become an unpleasant place to be, and some already dropped out,” Minnes said. In the study’s next phase, researchers hope to learn whether, as young adults, the participants have been able to overcome some of those challenges. About half the children are no longer with their biological mothers or relatives; one-fourth are in foster care or have been adopted, Minnes said. Twelve children have died since the study began. Others have moved, but continue to participate, she said.