A collaborative study led by ECHO researcher Liz Conradt, PhD of the University of Utah, examined the effects of simultaneous exposure to multiple substances—like tobacco, alcohol, and opioids—on outcomes in middle childhood. The team found that children ages 6 to 11 who were exposed prenatally to tobacco and multiple other substances were more likely to have below average verbal reasoning skills and higher levels of behavioral problems. Their research, titled “Prenatal Substance Exposure: Associations with Neurodevelopment in Middle Childhood,” is published in the American Journal of Perinatology.
To gather these results, the team collected data on prenatal exposure to substances such as alcohol, tobacco, marijuana, and opioids. A total of 256 mother-child pairs participated from two ECHO cohorts with locations in Rhode Island, Minnesota, Washington, California, and New York. When the children were between six and 11 years old, their caregivers were asked to report on the absence or presence of problem behaviors, such as aggression and anxiety. The team also collected data on verbal and nonverbal reasoning and problem solving skills.
Using this information, the researchers identified two specific groups—Group 1 had average verbal reasoning skills, average spatial reasoning skills, and normal levels of problem behavior. Children in this group were exposed to fewer substances before birth. Group 2 had below average verbal reasoning skills, but average spatial reasoning skills, and higher levels of problem behavior. The researchers found that children exposed to multiple substances prenatally, especially including tobacco, were more likely to be in Group 2. The effects of tobacco exposure on problem behavior and reasoning skills were stronger than expected.
“This study shows that children with prenatal tobacco exposure may be at risk for having higher levels of problem behaviors and more challenges with verbal reasoning during middle childhood,” said Conradt. “This is an important risk for pediatricians to keep in mind when conducting yearly check-ups on these children.”
The practice of grouping children based on problem behavior and reasoning skills was a novel approach and can be used in future studies to identify subgroups of children at risk for these outcomes.
Visit The Center for Parenting and Opioids and National Institute on Drug Abuse sites for more information on substance exposures and outcomes.