Neurodevelopmental outcome at 2-3 years in a group of drug-exposed children

To describe the cognitive, language and motor outcome at 2-3 year of age after having been exposed to various combinations of cannabis, amphetamines, buprenorphine, methadone and alcohol in pregnancy. To describe the cognitive, language and motor outcome at 2-3 year of age after having been exposed to various combinations of cannabis, amphetamines, buprenorphine, methadone and alcohol in pregnancy. 

This was a follow-up at two years of age in the prospective cohort study Children Exposed to Alcohol and/or Drugs in Intrauterine Life (CEADIL). In this prospective cohort study, 73 infants exposed to alcohol and/or other addictive drugs in pregnancy recruited from primary health care and included in a follow-up programme at St. Olavs Hospital, Trondheim University Hospital, Norway and 93 healthy unexposed infants in the control group recruited from the maternity ward at the same hospital were assessed with the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). The BSID-III is one of the most widely used standardized scales to assess a child's developmental level compared to age-related norms. Age-adjusted scaled and composite scores were calculated for cognitive, language and motor domains. Poor neurodevelopmental outcome was defined as a score below one standard deviation (SD) of the mean in the control group. Mean differences with 95% confidence intervals (CI) were calculated. The Hollingshead Two-Factor Index of Social Position was used to measure the caregiver’s socioeconomic status (SES).

Overall, both scaled and composite scores of BSID-III were considerably lower in the exposed group than in the control group. Mean differences adjusted for sex and parental SES were -17.7 (95% CI: -23.3 to-12.2) for the cognitive composite score, -17.6 (95% CI: -23.0 to 12.2 for the language composite score and -13.3 (95% CI: -18.6 to-8.0) for the motor composite score.

Neurodevelopmental outcome at 2-3 years of age was poorer in a group of children exposed to alcohol and/or drugs in pregnancy compared with a control group of healthy unexposed children. 

The results of the study could potentially alter intervention policies for children exposed to drugs and/or alcohol during pregnancy and have direct relevance for the implementation and organization of physiotherapy for these children in primary healthcare.