Oxytocin Effects on Cocaine-induced Maternal Neglect

Award: $40,000

Need/Problem:  At least 1% to 3% of women in the U.S. use cocaine during pregnancy. Prenatal cocaine abuse is linked to problems with mother-infant bonding and attachment, including child neglect and abuse.

This vulnerability may derive, in part, from altered maternal responses to infant cries and other signals, and from reduced maternal nurturing behaviors such as holding, touching and interacting with infant.

Mothers who have used cocaine during pregnancy report difficulty interacting with their infants, express subtle hostility (insensitivity and irritability) during feeding and play periods, and perceive infant cries as less arousing and requiring less maternal intervention. They tend to pick up and hold their infants less often than other mothers, even though their infants cry more.

These alterations in early mothering behaviors parallel those seen in animal studies of prenatal cocaine effects. Cocaine-related maternal child neglect and abuse has long-ranging negative psychiatric, cognitive, behavioral, physical and emotional consequences for children.

Currently there are no FDA-approved medications for treatment of cocaine addiction, making the need for new interventions all the more urgent in this at-risk group.

Grant Summary: We propose to study a promising new treatment that targets the negative effects that cocaine use during pregnancy has on mothering behavior.

We will test the effects of a two-week course of intranasal oxytocin, compared with placebo in 32 currently abstinent new mothers who have used cocaine during pregnancy.

Goals & Projected Outcomes: Animal models highlight the important role of oxytocin in initiation of maternal behavior, and experimental human studies show that oxytocin alters neural responses to stress and social interaction, improves social cognition and memory, increases trust and cooperation, decreases physiological stress responses and enhances physiological benefits of social support.

Research also consistently shows that early parental behaviors are the most powerful determinants of infants’ cognitive, emotional, behavioral and physical development. In drug-exposed families, studies document that the early post-natal environment, of which mother is the primary architect, appears to have at least as strong, if not stronger, effect on infant development as does in utero cocaine exposure.

Therefore, improving maternal behavior during this critical time may confer long-lasting benefits to both mother and child.  We hypothesize that oxytocin will enhance maternal nurturing behaviors and reduce mothers’ irritability, anxiety and physiologic stress reactivity.

Karen M. Grewen, Ph.D