Prenatal cocaine exposure and BMI and blood pressure at 9 years of age

BACKGROUND: Prenatal cocaine exposure has been linked to intrauterine growth retardation and poor birth outcomes; little is known about the effects on longer-term medical outcomes, such as overweight status and hypertension in childhood. Our objective was to examine the association between prenatal cocaine exposure and BMI and blood pressure at 9 years of age among children followed prospectively in a multisite longitudinal study evaluating the impact of maternal lifestyle during pregnancy on childhood outcome. DESIGN/Methods: This analysis includes 880 children (277 cocaine exposed and 603 with no cocaine exposure) with blood pressure, height, and weight measurements at 9 years of age. Regression analyses were conducted to explore the relationship between prenatal cocaine exposure and BMI and blood pressure at 9 years of age after controlling for demographics, other drug exposure, birth weight, maternal weight, infant postnatal weight gain, and childhood television viewing, exercise, and dietary habits at 9 years. Path analyses were used to further explore these relationships. Results: At 9 years of age, 15% of the children were prehypertensive and 19% were hypertensive; 16% were at risk for overweight status and 21% were overweight. A small percentage of women were exposed to high levels of prenatal cocaine throughout pregnancy. A higher BMI was noted in children born to these women. Path analysis suggested that high cocaine exposure has an indirect effect on systolic and diastolic blood pressures that is mediated through its effect on BMI. Conclusion: High levels of in-utero cocaine exposure are a marker for elevated BMI and blood pressure among children born full term.