Get access

Fetal Substance Exposure and Cumulative Environmental Risk in an African American Cohort


  • This research was funded by Grants R01-AA06966, R01-AA09524, and P50-AA07606 from the National Institute on Alcohol Abuse and Alcoholism, with supplemental support from a Minority Biomedical Research Support Grant S06-RR08167 from the National Institutes of Health, and a grant from the Joseph Young Sr. Fund from the State of Michigan. We thank Robert J. Sokol, Susan Martier, Joel Ager, and Erawati Bawle, our collaborators on this research; Douglas Barnett, for his suggestions; Neil Dodge, Lisa Chiodo, Renee Sun, Jeannine Tell, Brenda Tuttle, Jennifer Jester, and Raluca Corobana, who helped collect and analyze the data; and the mothers/caregivers and children who participated in the study. This study is based on a master’s thesis completed by C.Y. at Wayne State University.

concerning this article should be addressed to Sandra W. Jacobson, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, 2751 East Jefferson, Room 460, Detroit, MI 48207. Electronic mail may be sent to


Two models of vulnerability to socioenvironmental risk were examined in 337 African American children (= 7.8 years) recruited to overrepresent prenatal alcohol or cocaine exposure: The cumulative risk model predicted synergistic effects from exposure to multiple risk factors, and the fetal patterning of disease model predicted that prenatal insult will increase vulnerability to environmental risk. Four or more risks emerged as a threshold for poorer cognitive and behavioral outcome among the non-substance-exposed children, whereas substance-exposed children showed greater vulnerability to lower levels of environmental risk. Cumulative risk was associated with increased delinquent and internalizing behaviors only for the substance-exposed group. Results support the cumulative risk model for non-substance-exposed children and increased vulnerability to environmental risk among the substance-exposed group.