Studying 3-year-olds exposed to crack and powder cocaine
in the womb and a similar group of children who were not, UF
researchers found that disruptive behaviors in children
actually seem to be linked more closely to maternal
depression than prenatal cocaine exposure.
"In all of the various outcomes we have looked
at, people have expected very bad things," said Tamara D.
Warner, Ph.D., a postdoctoral associate in the UF College of
Medicine and lead author of the study. "These dire
predictions were made about this group of kids. This study
shows there really aren't the huge problems that we might
The researchers found that mothers, on average, reported
a high number of symptoms of depression, regardless of
whether they used cocaine during pregnancy, according to
findings published this month in the
Developmental and Behavioral Pediatrics. Biological
mothers also tended to report more behavioral problems than
nonmaternal caregivers and foster parents, who were caring
for about half the cocaine-exposed children by the time they
"One might have expected that caregivers who took on
children with prenatal cocaine exposure would've expected
(more problems) and reported a higher number of problems,"
Warner said. "But that wasn't the case."
The researchers studied 256 children, about half of whom
were exposed to cocaine before birth. Most of their mothers
were poor and black and lived in rural North Central
Poverty could explain why many of these mothers showed
signs of depression, and in turn, depression could explain
why mothers of cocaine-exposed and non-exposed children
tended to report more behavioral problems, such as
hyperactivity and impulsive behaviors, Warner said.
About 5 percent to 10 percent of children exhibit
disruptive behavioral problems. But the mothers UF
researchers studied reported that as many as 46 percent of
their children demonstrated certain disruptive problems,
Mothers could be showing signs of depression because of
their children's misbehaving ways, but researchers can't
pinpoint whether maternal depression causes misbehavior or
if disruptive behavior leads to depression.
"If you're poor and you need mental health services,
you're in bad shape," Warner said. "Both sets of moms were
reporting a large number of depressive symptoms and have
been from the beginning. And that is probably more likely to
result in emotional behavior problems for the children than
prenatal cocaine exposure."
Deborah Frank, Ph.D., a professor of pediatrics at Boston
University's Boston Medical Center, also noted that UF is
the only institution studying rural mothers, important
because urban mothers face different obstacles, such as
violence, which could potentially affect childhood behavior
and rates of maternal depression
"The very high rates of clinically important depression
in all the (maternal) caregivers are striking," said Frank,
who also studies prenatal cocaine exposure. "We're finding
that the most devastating effects are from the postnatal
environment, not the prenatal environment.
"None of this research should be taken as, 'It's OK to
use crack when you're pregnant," Frank added. "It's not
something women do for fun. It's something women do out of
Tackling that despair is still a problem that needs to
improve, said Marylou Behnke, M.D., a UF neonatology
professor and co-author of the study. Access to treatment
programs and mental health services is still poor for
mothers, she said.
Behnke and Fonda Davis Eyler, Ph.D., began studying
children exposed to cocaine prenatally in 1991. Their
research, funded by the National Institutes of Health's
National Institute on Drug Abuse, has debunked beliefs that
cocaine-exposed children would be malformed and not have the
same cognitive abilities as other children. Last year the
researchers reported that cocaine-exposed children exhibit
only subtle problem-solving differences in school. The
children they studied, including the 3-year-olds in the
current study, are in their early teens now.
"There were really dire things that are being predicted,"
Behnke said. "It's encouraging that we're not seeing those
kind of behavioral problems."