Prenatal exposure to cocaine and other substances: Its effect on newborn behavior and subsequent attachment behavior

The effects of prenatal substance exposure on newborn behavior and subsequent attachment quality was investigated in a sample of 29 drug-exposed infants. Participants in this study were part of a larger sample of high-risk women and their infants enrolled in a longitudinal study. Data regarding prenatal substance use, 4 weeks prior to delivery, was available for 17 infants. Prenatal substance use data were obtained from substance use histories, obstetrical and neonatal medical chart reviews and case manager notes. Frequency of substance use was reported as either $\u3e$1 time per day, 1 time per day, 3-6 times per week, 1-2 times per week, 1-3 times per month and unknown. Qualitative substance-use data were converted to quantitative data and were correlated with newborn behavior (NBAS Lester clusters and Als dimensions). At 1 month, maternal report of prenatal substance exposure 4 weeks prior to delivery was significantly associated with the reflex cluster of the NBAS. Increased amounts of drug-exposure was related to an infant displaying an increased number of abnormal reflexes at the 1-month NBAS assessment. NBAS individual items; inanimate auditory stimuli and self-quieting were found to be positively related to attachment security, suggesting that infants with these abilities may appear more attractive to their caregivers, thus helping to create a more positive goodness-of-fit between infant and caregiver. Prenatal substance use throughout pregnancy (n = 13) was found to be positively associated with security of attachment (p =.03). Other factors undetected within this study (i.e. social support), may have influenced interactions between infant and caregiver and subsequently increased the potential for secure attachment. Finally, an infant\u27s ability to attend to stimuli was found to be positively related to the attachment subcategories A1-B2 in the Strange Situation, lending further support to the idea that infant temperamental characteristics may influence whether infants are more likely to be classified as avoidant or resistant , but not secure vs. insecure. Findings from this study suggest that infants exposed to drugs prenatally continue to show physiological abnormalities through the first month of life. The results were discussed in terms of implications for child development and future research