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Adolescents prenatally exposed to cocaine more likely to have sex at an early age

Adolescents exposed to cocaine in utero were 2.2 times more likely to engage in sexual intercourse earlier than adolescents unexposed to cocaine, according to study findings in Drug and Alcohol Dependence.

“Maternal substance use during pregnancy continues to be a serious public health problem, with approximately 214,000 infants exposed to illicit drugs, including cocaine, in utero each year in the United States,” study researcher Meeyoung Oh Min, MSW, PhD, of Case Western Reserve University, and colleagues wrote. “[Prenatal cocaine exposure] disrupts the monoaminergic neurotransmitter system (dopamine, norepinephrine, serotonin) in the prefrontal cortex, affecting emotional and behavioral arousal and regulation, stress response, and executive function, all of which are risk factors for engaging in early sexual behavior.”

Meeyoung Oh Min

Researchers evaluated 415 newborns and their birth mothers at birth, and then at ages 6, 12 and 18 months, 2, 4, 6, 9 to 12 years and at 15 years. At baseline, 218 infants were exposed to cocaine in utero. At age 15 years, 354 adolescents participated in follow-up. Externalizing behavior was assessed using the Youth Self-Report at age 12 years and sexual health was assessed at age 15 years using the Youth Risk Behavior Surveillance System.

Logistic regression analysis indicated adolescents with prenatal cocaine exposure were 2.2 times more likely to engage in sexual intercourse early (38% vs. 28%; P < .01). This association was fully mediated by externalizing behavior among females but not males.

Of adolescents prenatally exposed to cocaine, 29% lived in foster or adoptive care, compared with 23% of unexposed adolescents. Among adolescents with prenatal cocaine exposure who lived with their birth mother, 42% reported having sexual intercourse before age 15 years.

Eighteen percent of the study cohort (37 with prenatal cocaine exposure, 27 without) reported having sex as young as age 13 years.

Levels of lead in the blood during preschool years was associated with a greater chance of engaging in sexual intercourse early (OR = 2.6; 95% CI, 1.4-4.7; P < .002).

Researchers found that more parental monitoring decreased chances for early sexual intercourse, while exposure to violence increased risk.

“Interventions focusing on strengthening parental monitoring and decreasing violence and lead exposure may be promising in reducing early sexual initiation among high-risk prenatally cocaine/poly-drug exposed adolescents. Interventions targeting externalizing behavior in girls may decrease early sexual behavior and promote sexual health,” Min and colleagues concluded. – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.