Despite the fact that methamphetamine (MA) use is very high in some regions, Iittle is known about the potential neurotoxic effects of prenatal MA exposure on the development of children. We have established a Community Research Network (CRN), to conduct a longitudinal study of prenatal MA exposure and child outcome in four areas (Iowa, Oklahoma, California, and Hawaii) in which MA use is prevalent. The data collection sites include 9 hospitals with a combined annual delivery rate of approximately 27,300 newborn infants. Exposure status will be determined by maternal self-report and/or GC/MS confirmation of a positive meconium screen. We are projecting an average 4 percent prevalence rate of prenatal MA exposure across the sites. The sample will Include 254 subjects in the MA exposed group and 254 subjects in the comparison group matched for other drug use, prematurity, social class, gender and race. This sample size provides sufficient power to detect small statistical effects with controls for appropriate covariates (e.g., polydrug use, medical status, social class). Our plan is to conduct a three-year longitudinal study with 1 year to screen and recruit the sample and developmental follow-up in the newborn period, 1, 2 and 3 years and a home visit at 18 months. Measures of the child include domains of arousal regulation, cognition, social relationships, neuromotor, neuroendocrine function, and medical status. Measures of psychosocial risk factors include caregiving context and caregiver characteristics. We will test hypotheses related to the effects of prenatal MA exposure on child outcome when covariates including other drug use are controlled and hypotheses related to the role of psychosocial risk factors mediating effects of prenatal MA exposure on child outcome. This study will enable us to bring to bear experiences and advances in methods and lessons learned from the study of prenatal exposure to other drugs to the study of prenatal MA exposure, as well as research and clinical expertise with MA. This will be the first large scale study of the developmental consequences of prenatal MA exposure and will advance our scientific understanding of this emerging problem and enhance our ability to develop appropriate interventions for these children and their families.
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