Latent Class Analysis of Prenatal Substance Exposure and Child Behavioral Outcomes.
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2023-05
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Abstract
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To predict behavioral disruptions in middle childhood, we identified latent classes of prenatal substance use.Study design
As part of the Environmental influences on Child Health Outcomes (ECHO) Program, we harmonized prenatal substance use data and child behavior outcomes from 2,195 women and their 6- to 11-year-old children across 10 cohorts in the United States and used latent class-adjusted regression models to predict parent-rated child behavior.Results
Three latent classes fit the data: low use (90.5%; n=1,986), primarily using no substances; licit use (6.6%; n=145), mainly using nicotine with a moderate likelihood of using alcohol and marijuana; and illicit use (2.9%; n=64), predominantly using illicit substances along with a moderate likelihood of using licit substances. Children exposed to primarily licit substances in utero had higher levels of externalizing behavior than children exposed to low or no substances (p=.001, d=.64). Children exposed to illicit substances in utero showed small but significant elevations in internalizing behavior than children exposed to low or no substances (p<.001, d=.16).Conclusions
The differences in prenatal polysubstance use may increase risk for specific childhood problem behaviors; however, child outcomes appeared comparably adverse for both licit and illicit polysubstance exposure. We highlight the need for similar multi-cohort, large-scale studies to examine childhood outcomes based on prenatal substance use profiles.Type
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Maylott, Sarah E, Elisabeth Conradt, Monica McGrath, Emily A Knapp, Xiuhong Li, Rashelle Musci, Judy Aschner, Lyndsay A Avalos, et al. (2023). Latent Class Analysis of Prenatal Substance Exposure and Child Behavioral Outcomes. The Journal of pediatrics. p. 113468. 10.1016/j.jpeds.2023.113468 Retrieved from https://hdl.handle.net/10161/27478.
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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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