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.
Greller HA, Hoffman RS. Lead Exposure and Cognitive Outcomes of Children With Prenatal Cocaine Exposure. JAMA. 2004;292(9):1021. doi:10.1001/jama.292.9.1021-a
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