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Lead Exposure and Cognitive Outcomes of Children With Prenatal Cocaine ExposureLead Exposure and Cognitive Outcomes of Children With Prenatal Cocaine Exposure

JAMA. 2004;292(9):1021-1021. doi:10.1001/jama.292.9.1021-a
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AUTHOR INFORMATION

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

LEAD EXPOSURE AND COGNITIVE OUTCOMES OF CHILDREN WITH PRENATAL COCAINE EXPOSURE

To the Editor: We read with interest the article by Dr Singer et al1 concerning the cognitive outcomes of preschool children with prenatal exposure to cocaine. The authors make a concerted effort to control for multiple confounding variables, including sex, intelligence of caregivers, and degree of cocaine exposure. They also stress the importance of the environment in which the children are placed as a determinant of their cognitive outcome. However, they do not address lead levels, an important environmental variable known to be strongly associated with both socioeconomic status and development of cognitive ability.2 5 We believe that the absence of this information may weaken their conclusions.

References
Singer LT, Minnes S, Short E.  et al.  Cognitive outcomes of preschool children with prenatal cocaine exposure.  JAMA.2004;291:2448-2456.
PubMed
Tong S, McMichael AJ, Baghurst PA. Interactions between environmental lead exposure and sociodemographic factors on cognitive development.  Arch Environ Health.2000;55:330-335.
PubMed
Not Available.  Blood lead levels in young children—United States and selected states, 1996-1999.  MMWR Morb Mortal Wkly Rep.2000;49:1133-1137.
PubMed
Mendelsohn AL, Dreyer BP, Fierman AH.  et al.  Low-level lead exposure and cognitive development in early childhood.  J Dev Behav Pediatr.1999;20:425-431.
PubMed
Tong S, Baghurst PA, Sawyer MG, Burns J, McMichael AJ. Declining blood lead levels and changes in cognitive function during childhood: the Port Pirie Cohort Study.  JAMA.1998;280:1915-1919.
PubMed

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Singer LT, Minnes S, Short E.  et al.  Cognitive outcomes of preschool children with prenatal cocaine exposure.  JAMA.2004;291:2448-2456.
PubMed
Tong S, McMichael AJ, Baghurst PA. Interactions between environmental lead exposure and sociodemographic factors on cognitive development.  Arch Environ Health.2000;55:330-335.
PubMed
Not Available.  Blood lead levels in young children—United States and selected states, 1996-1999.  MMWR Morb Mortal Wkly Rep.2000;49:1133-1137.
PubMed
Mendelsohn AL, Dreyer BP, Fierman AH.  et al.  Low-level lead exposure and cognitive development in early childhood.  J Dev Behav Pediatr.1999;20:425-431.
PubMed
Tong S, Baghurst PA, Sawyer MG, Burns J, McMichael AJ. Declining blood lead levels and changes in cognitive function during childhood: the Port Pirie Cohort Study.  JAMA.1998;280:1915-1919.
PubMed
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