Prenatal drug exposure and the conceptualization of long-term effects

• Published in: Scandinavian journal of psychology 2002-02, Vol.43 (1), p.41-47
• Main Authors: Moe, Vibeke, Slinning, Kari
• Format: Article
• Language: English
• Subjects: Adult; Caregivers; Environment; Female; Foster Home Care; Humans; Male; Pregnancy; Prenatal Exposure Delayed Effects; Time
• ISSN: 0036-5564; 1467-9450
• DOI: 10.1111/1467-9450.00267

This paper discusses several factors affecting the development of children prenatally exposed to drugs. In the “first generation” of research in this field a main factor model of disease formed the basis for a belief in the feasibility of detecting the direct pharmacological or teratogenic effects of drug exposure on long‐term child development. However, the clustering of confounding variables has constituted a major problem in identifying these effects. In the last few years a “second generation” of research in this field has emerged, and investigators have moved beyond simple main‐effect models. The importance of controlling for confounding variables has been underscored. However, prenatal substance exposure is still often studied within a teratology model where the main goal is the search for unique effects of a specific drug or substance. Based on this review it is suggested that an appropriate model for understanding the development of drug‐exposed children cannot be based on a main‐effect perspective. Rather, such a model must evolve from a contextual perspective, and it is suggested that a transactional model, where both potential risk factors and protective factors are considered, should replace the traditional teratology model in this field.