Journal Mobile Options
Table of Contents
Vol. 13, No. 2, 2007
Issue release date: March 2007

Developmental Outcome in Children with Intrauterine Exposure to Substances

Steinhausen H.-C. · Blattmann B. · Pfund F.
To view the fulltext, log in and/or choose pay-per-view option

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


The developmental outcome of children born to Swiss substance-dependent mothers in a residential treatment program was studied in a sample of 61 children ranging from infancy to preadolescence (mean age = 5.10, SD = 3.10 years) by use of age-appropriate tests of intelligence. A large list of biological and psychosocial risk factors was tested for associations with outcome in the children. The mean profile of test findings across all age ranges was significantly lower than population norms and there was an excess of children with subnormal intellectual functioning. Performance IQ was associated negatively only with intrauterine substance exposure, but with none of the other risk factors. Among the various substances, predominantly heroin or methadone were responsible for this association when controls for nicotine or cannabis consumption were made. The study provides further evidence that intrauterine exposure to heroin and methadone negatively affects the developmental outcome in the offspring of substance-dependent mothers.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Alessandri SM, Bendersky M, Lewis M: Cognitive functioning in 8- to 18-month-old substance-exposed infants. Dev Psychol 1998;34:565–573.
  2. Bennet DS, Bendersky M, Lewis M: Children’s intellectual and emotional-behavioral adjustment at 4 years as a function of cocaine exposure, maternal characteristics and environmental risk. Dev Psychol 2002;38:648–658.
  3. Singer LT, Arendt R, Minnes S, et al: Cognitive and motor outcomes of cocaine-exposed infants. JAMA 2002;287:1952–1960.
  4. Hurt H, Malmud E, Betancourt LM, Brodsky NL, Giannetta JM: A prospective comparison of developmental outcome of children with in utero cocaine exposure and controls using the Battelle Developmental Inventory. J Dev Behav Pediatr 2001;22:27–34.
  5. Kilbride H, Castor C, Hoffman E, Fuger KL: Thirty-six-month outcome of prenatal cocaine exposure for term or near-term infants: impact of early case management. J Dev Behav Pediatr 2000;21:19–26.
  6. Wasserman GA, Kline JK, Bateman DA, et al: Prenatal cocaine exposure and school-age intelligence. Drug Alcohol Depend 1998;50:203–210.
  7. Griffith DR, Azuma SD, Chasnoff IJ: Three-year outcome of children exposed prenatally to substances. J Am Acad Child Adolesc Psychiatry 1994;33:20–27.
  8. Chasnoff IJ, Griffith DR, Freier C, Murray J: Cocaine/polysubstance use in pregnancy: two-year follow-up. Pediatrics 1992;89:284–289.
  9. Frank DA, Jacobs RR, Beeghly M, et al: Level of prenatal cocaine exposure and scores on the Bayley Scales of Infant Development: modifying effects of caregiver, early intervention and birth weight. Pediatrics 2002;110:1143–1152.
  10. Arendt R, Angelopoulos J, Salvatore A, Singer L: Motor development of cocaine-exposed children at age two years. Pediatrics 1999;103:86–92.
  11. Chiriboga CA, Brust JCM, Bateman D, Hauser WA: Dose-response effect of fetal cocaine exposure on newborn neurologic function. Pediatrics 1999;103:79–85.
  12. Delaney-Black V: Prenatal cocaine and neonatal outcome: evaluation of dose-response relationship. Pediatrics 1996;98:735–740.
  13. Swanson J, Lerner M, March J, Gresham FM: Assessment and intervention for attention-deficit/hyperactivity disorder in the schools – lessons from the MTA study. Pediatr Clin North Am 1999;46:993.
  14. Johnson JM, Seikel JA, Madison CL, Foose SM, Rinard KD: Standardized test performance of children with a history of prenatal exposure to multiple substances/cocaine. J Commun Disord 1997;30:45–73.
  15. Bender SL, Word CO, DiClemente R, et al: The developmental implication of prenatal and/or postnatal crack cocaine exposure in preschool children: a preliminary report. J Dev Behav Pediatr 1995;16:418–424.
  16. Mentis M, Lundgren K: Effects of prenatal exposure to cocaine and associated risk factors on language development. J Speech Hear Res 1995;38:1303–1318.
  17. Malakoff ME, Mayes LC, Schottenfield RS: Language abilities of preschool-age children living with cocaine using mothers. Am J Geriatr Psychiatry 1994;2:346–354.

    External Resources

  18. Messinger DS, Bauer CR, Das A, et al: The maternal lifestyle study: cognitive, motor and behavioural outcomes of cocaine-exposed and opiate-exposed infants through three years of age. Pediatrics 2004;113:1677–1685.
  19. Bunikowski R, Grimmer I, Heiser A, et al: Neuro-developmental outcome after prenatal exposure to opiates. Eur J Pediatr 1998;157:724–730.
  20. Ornoy A, Segal J, Bar-Hamburger R, Greenbaum C: Development outcome of school-age children born to mothers with heroin dependency: importance of environmental factors. Dev Med Child Neurol 2001;43:668–675.
  21. Grattan MP, Hans SL: Motor behavior in children exposed prenatally to substances; in Chandler LS, Lane SJ (eds): Children with Prenatal Substance Exposure. London, Haworth Press, 1997, pp 89–109.
  22. Moe V: Foster-placed and adopted children exposed in utero to opiates and other substances: prediction and outcome at four and a half years. J Dev Behav Pediatr 2002;23:330–339.
  23. Morrison DC, Cerles L, Montaini-Klovdahl L, Skowron E: Prenatally substance-exposed toddlers: cognitive and social development. Am J Orthopsychiatry 2000;70:278–283.
  24. Van Baar AL, de Graaff BMT: Cognitive development at preschool age of infants of substance dependent mothers. Dev Med Child Neurol 1994;36:1063–1075.
  25. Chasnoff IJ, Burns KA, Burns WJ, Schnoll SH: Prenatal substance exposure: effects on neonatal and infant growth and development. Neurobehav Toxicol Teratol 1986;8:357–362.
  26. Rosen TS, Johnson HL: Long-term effects of prenatal methadone maintenance; in Pinkert T (ed): Current Research on the Consequences of Maternal Substance Abuse. NIDA Res Monogr 59, DHHS Publ No (ADM), 1985, pp 85–1400.
  27. Lifschitz MH, Wilson GS, Smith E, Desmond MM: Factors affecting head growth and intellectual function in children of substance addicts. Pediatrics 1985;75:269–274.
  28. Kaltenbach K, Finnegan LP: Developmental outcome of children born to methadone-maintained women: a review of longitudinal studies. Neurobehav Toxicol Teratol 1984;6:271–275.
  29. Strauss ME, Lessen-Firestone JK, Chavez CJ, Stryker JC: Children of methadone-treated women at five years of age. Pharmacol Biochem Behav 1979;11:3–6.
  30. Schuler ME, Nair P, Kettinger L: Substance-exposed infants and developmental outcome. Effects of a home intervention and ongoing maternal substance use. Arch Pediatr Adolesc Med 2003;157:133–138.
  31. Beckwith L, Howard J, Espinosa M, Tyler R: Psychopathology, mother-child interaction, and infant development: substance-abusing mothers and their offspring. Dev Psychopathol 1999;11:715–725.
  32. Carta JJ, Atwater JB, Greenwood CR, et al: Effects of cumulative prenatal substance exposure and environmental risks on children’s developmental trajectories. J Clin Child Psychol 2001;30:327–337.
  33. De Cubas MM, Field T: Children of methadone-dependent women: develop-mental outcomes. Am J Orthopsychiatry 1993;63:266–276.
  34. Bayley N: Bayley Scales of Infant Development, ed 2. San Antonio, Psychological Corporation, 1993.
  35. Eggert D: HAWIVA. Hannover-Wechsler-Intelligenztest für das Vorschulalter. Bern, Huber, 1975.
  36. Bründler M, Schallberger U: HAWIK-R. Hamburg-Wechsler-Intelligenztest für Kin- der, Rev 1983. Ergänzungsband zum Handbuch. Bern, Huber, 1988.
  37. Oswald WD, Roth E: Der Zahlen-Verbindungstest (ZVT). Ein sprachfreier Intelligenz-Schnell-Test. Göttingen, Hogrefe, 1978.
  38. Reitan RM: Trail Making Test: Manual for Administration, Scoring and Interpretation. Indianapolis, Indiana University Press, 1956.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50