Prenatal Substance Exposure: Associations with Neurodevelopment in Middle Childhood.
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2023-05
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Single-substance exposure effects on neurodevelopmental outcomes, such as problem behavior and intelligence quotient (IQ), have been studied in children for decades. However, the long-term consequences of polysubstance exposure are poorly understood.Study design
Longitudinal neurodevelopmental data were gathered from cohorts across the United States (U.S.) through the Environmental influences on Child Health Outcomes (ECHO) Program. Data on prenatal exposure to opioids, nicotine, marijuana, and alcohol were collected from children ages 6-11 years (N=256). Problem behavior was assessed using the Child Behavior Checklist (school-age version, CBCL-Sch), and verbal IQ (VIQ) and performance IQ (PIQ) were assessed using the Weschler Intelligence Scale for Children, Fifth Edition (WISC-5). We first identified latent profiles in the overall sample, then evaluated differences in profile membership for children with and without prenatal substance exposure.Results
Latent profile analysis identified two mutually exclusive categories: average VIQ and PIQ, with typical problem behavior; and below-average VIQ with average PIQ and clinically significant problem behavior. Children with prenatal nicotine and polysubstance exposures were more likely to be classified in the below-average VIQ, elevated problem behavior profile compared with children without prenatal nicotine exposure.Conclusions
The presence of clinically significant behavior problems in children with average PIQ, but below-average VIQ, could represent a unique endophenotype related to prenatal nicotine exposure in the context of other prenatal substance exposures.Type
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Conradt, Elisabeth, Monica McGrath, Emily Knapp, Xiuhong Li, Rashelle J Musci, Maxwell Mansolf, Sean Deoni, Sheela Sathyanarayana, et al. (2023). Prenatal Substance Exposure: Associations with Neurodevelopment in Middle Childhood. American journal of perinatology. 10.1055/a-2090-5293 Retrieved from https://hdl.handle.net/10161/27481.
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Elisabeth D Conradt
As a clinical and developmental psychologist, my mission is to promote infant and early childhood mental health. My scientific focus is to better understand the intergenerational transmission of risk for mental health problems. In the CAN lab we document how exposures the pregnant person had throughout the lifespan can impact the pregnancy, preterm birth risk, newborn neurodevelopment, and susceptibility for psychopathology. Emotion dysregulation is a transdiagnostic, early-emerging marker of risk for a wide range of psychiatric outcomes, including ADHD, mood, and bipolar disorder. We study how emotion dysregulation – a modifiable intervention target – emerges early in development to inform preventive intervention efforts that begin prenatally and in the first year of life. Pregnant people with emotion dysregulation are also susceptible to a wide range of health risk behaviors, including substance use. Another line of research involves understanding how prenatal substance exposure, in combination with associated environmental exposures, affects neurodevelopment and mental health outcomes in early childhood. The overarching goal of my research is to leverage this science to prevent intergenerational transmission of mental health problems.
I am Associate Professor in Psychiatry, and adjunct Associate Professor of Pediatrics at Duke University. Before coming to Duke, I was Associate Professor in the Department of Psychology, and adjunct Associate Professor in the Departments of Obstetrics & Gynecology and Pediatrics at the University of Utah. I received my PhD in Clinical Psychology at the University of Oregon and completed my clinical internship in Early Childhood Mental Health at the Children’s Hospital of Philadelphia. I have been continuously funded by the NIH since 2011 when I was awarded an F32 postdoctoral fellowship to examine the biological embedding of early life stress in children with prenatal substance exposure at Brown University. My work has been covered in media outlets like NPR and I have received multiple national and international early career research awards.
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