The Problem of Prenatal Cocaine Exposure

Abstract

VALID concern about the high rate of cocaine use among pregnant women has resulted in an apparent rush to judgment about the extent and permanency of specific effects of intrauterine cocaine exposure on newborns. Predictions of an adverse developmental outcome for these children are being made despite a lack of supportive scientific evidence. Whatever the true outcome, we are concerned that premature conclusions about the severity and universality of cocaine effects are in themselves potentially harmful to children. Although the prevalence of cocaine/crack use is declining (in 1990 an estimated 6.6 million individuals reported use in the preceding year compared with 12 million in 1988), certain groups continue to use the drug at high or increasing rates.^1,2Also, more women of childbearing age seem to be affected by cocaine use compared with previous drug epidemics.³At present no reliable national estimates of the extent or patterns of cocaine