Abstract:
Methamphetamine (MA) use in pregnancy has been linked to deficits in fetal growth and newborn neurobehavioural functioning, and later problems in cognitive, psychomotor and behavioural functioning. Beyond the direct biological impact of MA exposure, maternal drug use may affect the child indirectly through the negative lifestyle and psychological factors associated with drug use. Of particular concern is the evidence that links drug dependence and maternal psychological distress with negative parenting behaviours and poor developmental outcomes for children. The specific aim of this investigation was to examine the associations between prenatal MA exposure and indicators of maternal behavioural health (postnatal drug use and psychological functioning) on child neurobehavioural disinhibition measures at 4.5 years. The sample in this longitudinal investigation included 83 children with prenatal MA exposure and 97 matched comparison children. Neurobehavioural disinhibition, involving lack of behavioural control and poor emotion regulation, was assessed using a Gift Delay of Gratification task and maternal report on the Strengths and Difficulties Questionnaire (SDQ) and the Brief Rating Inventory of Executive Functioning - Pre-school Edition (BRIEF-P). Hierarchical linear modelling was used to estimate suspected causal relationships between indicators of maternal behavioural health at four time points across the 4.5 year follow-up, according to self-report on the Substance Use Inventory (SUI) and Brief Symptom Inventory (BSI) scores. Prenatal MA exposure was not associated with any measure of child neurobehavioural disinhibition at 4.5 years. Postnatal drug use and psychological distress were associated with all measures of child neurobehavioural disinhibition. However, when considered within a combined model, only maternal psychological functioning remained significant. In light of the significant role that maternal functioning plays in the development of challenging behaviours, it is clear that treatment that addresses both mental health and substance use behaviours in mothers who use methamphetamine are warranted.
