Rivkin notes that the study is also the first to document joint long-term neuroanatomic effects on the brain of prenatal cocaine, cigarette and alcohol exposures. Moreover, while previous studies have documented brain effects of prenatal alcohol exposure, these studies were mostly limited to children with fetal alcohol syndrome, a diagnosis that was excluded in the current study.
Although investigators initially set out to study cocaine exposure, they were struck by the finding of brain effects of prenatal tobacco exposure. Approximately 20 percent of women who smoke continue to smoke during pregnancy, Rivkin says. From the vantage point of preventive health care, it is important to determine the consequences on brain structure of prenatal exposure to cigarettes, alone and in combination with other substances.
Rivkin emphasizes that the number of children studied was too small to find statistically significant effects of single substances after controlling for exposure to other agents. The study was also too small to consider the effects of different levels of exposure. But the overall results are highly suggestive. Were hopeful to be able to study the whole sample of 150 children followed at Boston Medical Center, which will permit such determinations, Rivkin says.
Both investigators concur that health care providers should offer pregnant women comprehensive care to help them reduce use of all psychoactive substances. Public health campaigns should not ignore the risks of some substances while focusing on others, as it may well be that the greater the number of total prenatal exposures, the higher the chance there will be adverse and lasting consequences for the developing brain.
|Contact: James Newton|
Children's Hospital Boston