The association of prenatal cocaine use and childhood trauma with psychological symptoms over 6 years.

The use of cocaine and other drugs during pregnancy may have serious public health consequences. The objective of this study was to determine if the use of cocaine prenatally identifies women for ongoing risk of psychological symptoms. Four hundred and two women (207 cocaine using [C], 195 non-cocaine using [NC]) were assessed for rates of clinically elevated psychological symptoms shortly after childbirth, 6.5 months and 1, 2, 4 and 6 years after using the Brief Symptom Inventory (BSI). Generalized estimating equation modeling (GEE) was used to compare psychological symptom severity, controlling for confounding factors including early childhood trauma. Results indicated that women identified as having used cocaine during pregnancy had clinically elevated psychological distress (OR = 1.76, 95%CI = 1.15-2.71, p = 0.01), psychoticism (OR = 1.97, 95%CI = 1.41-2.76, p = 0.001), interpersonal sensitivity (OR = 2.34; 95%CI = 1.65-3.34; p < 0.0001) and phobic anxiety (OR = 1.86; 95%CI = 1.24-2.79) across all assessments compared to NC women. Childhood emotional abuse was also independently associated with psychological distress. Women who use cocaine during pregnancy should be recognized as at very high risk of ongoing clinically elevated psychological symptoms and should receive early and regular assessments and intervention for mental health and substance use problems.