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The myth of crack babies - collection of articles
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THE PERCENTAGE OF CRACK BABIES BORN AT ANY GIVEN HOSPITAL IS
APPROXIMATELY ZERO.
While continually heckling me at a public presentation, a medical man
finally shouted in fury, "You're saying all the crack babies coming into my
emergency room since 1976 are my imagination!" I asked if he agreed that
crack first appeared around 1986, and the medical man nodded. "Then," i
went on, "the first ten years you observed crack babies it *was* your
imagination, because the substance didn't exist." The medical man looked
embarassed and shut up.
Drug warriors often claim 375,000 crack babies are born annually in the
United States, each one with developmental deficits costing $500,000 to $1
million in medical care. That claim can be tested in several ways.
First we can check if neonatal units are indeed expending $375 trillion
per year on crack babies. The latest published figures for national health
expenditures are from 1987, contained in the "Statistical Abstract of the
United States 1990". The grand total by consumers, government, and
philanthropies for all health purposes (including hospital care, nursing
homes, physician office calls, prescriptions, medical research, and
hospital building construction) was $500 billion. Costs for all hospital
care were $195 billion. Crack baby expenditures cited by drug warriors are
2,000 times greater than the total sum spent for *all* care of *all*
persons in *all* hospitals.
Second, we can extrapolate from drug use patterns. Drug warriors claim
that a single use of crack devastates a fetus, but this claim is
incorrect. The claim is also sad because it encourages abortion among
women desiring pregnancy. To cause developmental damage in a fetus, a
pregnant woman must abuse crack in the way that hospitalized alcoholics
abuse alcohol. Studies of cocaine users find that 2.5 percent to 10
percent abuse the drug--in all varieties. Given four million live births
annually in the United States, 375,000 crack babies born is about 9.4
percent. To get that many crack babies, every pregnant woman in the United
States must be on cocaine.
In reality, few women are using cocaine when they become pregnant, and
almost all of those who *are* users will stop upon learning they are
pregnant. The percentage of crack users among women of childbearing
age--let alone pregnant--is so small that the federal government is unable
to make an estimate (National Institute on Drug Abuse, National Household
Survey on Drug Abuse: Population Estimates 1990).
Yet another way to determine the number of crack babies is to phone
hospitals and ask them. St. Luke's reports 0 percent. Research, 0 percent.
Baptist, 0 percent. KU Med Center, 0 percent. That doesn't mean they
*never* see a crack baby, but the number is so small as to be virtually
unnoticeable. [Typist's Note: All names above are hospitals in Kansas City,
Missouri, for those of you who aren't Missourians.]
Around Kansas City people repeatedly tell me that 15 percent of infants
born at Truman Medical Center are crack babies. That story is wrong.
Truman does not monitor each mother and newborn for cocaine, so no figure
exists. A one-month survey in 1989 found that 15 percent of mothers giving
birth at Truman showed *exposure* to cocaine, *not* that their infants were
crippled by crack or any other form of cocaine. Even so, 15 percent
exposure is far higher than would be expected from a general population.
And in fact, unlike many hospitals, Truman solicits pregnant women from
drug abuse treatment programs. Thus Truman neonatal statistics do not
reflect experience in the general population. Also, among low-income
pregnant women--exactly the maternity clientele in which Truman
specializes--a false rumor circulates that cocaine reduces time spent in
labor. "Cocaine-exposed" infants may be from mothers using cocaine for
what they believe is medication rather than recreation.
In hospitals serving affluent women who can buy enough cocaine to wreck
fetal development, the percentage of crack babies should be higher than in
hospitals serving impoverished women. The opposite is reported. We should
ask whether *cocaine* is being blamed for medical problems caused by
*poverty*. Cocaine was available for a century before anyone first noticed
a problem among pregnant women in the 1980s. In 1989 analysts examining
files of the Society of Pediatric Research discovered that in 81 percent of
reports claiming fetal damage from cocaine, medical personnel failed to
determine if the pregnant woman actually *used* cocaine.
"The scientific world is in the midst of correcting itself," declares
Nancy Day, associate professor of psychiatry and epidemiology at the
University of Pittsburgh School of Medicine. "There will never be this
horde of crack-crazed babies affecting the school system. We are not
finding the birth defects that earlier studies have reported."
-!---------------------------------------------------------------------------
Rob Carlson <[email protected]>
-!--------------------------------------------------------------------------
Subject: Placenta barrier to cocaine, study finds]
This article appeared in the Calgary Herald in Canada on
Saturday, June 11, 1994.
By: Mark Lowey
Placenta barrier to cocaine, study finds
TORONTO - Developmental problems in children exposed to cocaine
prior to birth may be due more to neglect at home than the drug's
longterm effects, a study suggests.
"Cocaine babies," a term used by the popular media to label
children with problems, is a misnomer, said Dr. Carmine Simone,
researcher at the Hospital for Sick Children in Toronto.
He co-authored the study to be published in the American
Journal of Obstetrics and Gynecology, with Dr. Gideon Koren, head
of clinical pharmocology at the hospital.
Prenatal exposure to cocaine may be a merker of other problems
at home, such as child abuse, neglect and substance abuse by
parents, Simone said.
In fact, researchers found that the placenta in the womb may
actually help protect the fetus from cocaine abuse by the mother.
Using placenta recovered from full term births, researchers
devised apparatus that simulates conditions in the womb when the
mother takes cocaine.
"We can mimick the way women take drugs," Simone said. "It's a
model for what's happening."
The placenta is usually discarded after birth, he noted, adding
the study was conducted according to strict ethical guidelines
and no fetuses were involved.
Results showed the placenta appears to act as a barrier to
cocaine. It is able to absord about one-third of the
administered dose, with about one-third getting through that
would affect the fetus. The rest is eliminated.
Simone said this situation may be due to the way cocaine is
taken, in staggered "hits" as the high wears off. The placenta
appears to metabolize and eliminate the drug between the hits.
Children of cocaine abusers show no proven lasting
physiological or developmental effects due to their experiences
in the womb, said study co-author Koren.
A study involving three Toronto hospitals found about six per
cent of new borns, or one in 16, showed exposure to cocaine in
the final three months before birth.
But if the placenta buffers exposure, this would help explain
why only 10 of 120 of the babies needed resuscitation or other
intensive care.
Other research shows cocaine-exposed newborns are smaller than
average and much less healthy.
Subject: Crack Babies (was Re: Can a baby be born with a drug addiction?)
In Article <[email protected]>, [email protected] (DaveHatunen)
wrote:
>In article <[email protected]>,
>michael zarlenga <[email protected]> wrote:
You seem to be confusing cocaine with some other drug. Cocaine addicts don't
typically maintain themselves on cocaine the way heroin users do. They
tend to go on binges. Thus, the term "cold turkey" isn't really relevant.
One never quits cocaine by tapering the dose.
Nor is cocaine withdrawal particularly ugly. Cocaine withdrawal is
characterized by the DSM-IV as consisting of dysphoric mood plus two or more
of the following: fatigue, vivid unpleasant dreams, insomnia or hypersomnia,
increased appetite, and psychomotor agitation or retardation. These have to
cause clinically significant levels of distress or impairment.
I also have some doubts about the appropriateness of calling these infants
addicted since a large component of addiction is behavioral and these
infants have never acquired any drug taking behaviors. In other words, they
may have tweaked receptors, but they won't have any problems staying away
>from crack pipes in the near future.
>My wife and I are licensed foster parents specializing in the care of
>medically fragile infants. We have had quite a few 'crack babies",
>usually direct from the maternity ward. And we have had non-crack, but
>heroine babies. The crack babies are different. And given what they go
>through during withdrawal, they had to be addicted.
Uncontrolled clinical observations like this are essentially worthless since
there are numerous biases in which children are identified as "crack babies."
Anyone who is interested in a more balanced assessment of the "crack baby"
myth should check out _Neurotoxicology and Teratology_, Vol 15, pp. 281-312,
1993. It's a series of commentaries by various researchers in the field.
It nicely documents the history of the media hysteria and tentatively
concludes that, while cocaine is not a good thing for pregnant women to do,
it
appears to be a relatively weak teratogen that increases risk of
genitourinary
tract malformations in _some_ of the cases where women use cocaine in high
doses on a near daily basis. This "small group of individuals may have a
unique but as yet undefined genetic and/or physiological susceptibility."
Other complications may be estabilshed, but it hasn't happened yet.
The observant reader may have noticed a pattern with respect to the alleged
effects of illegal drugs. For example, after LSD rose to prominence as a
recreational drug, some poorly controlled studies reported that
it caused chromosomal breakage. These studies were widely circulated.
Later,
better designed studies failed to replicate these findings. However, these
studies were reported in a quieter manner. Furthermore, "lack of evidence is
not evidence of lack." The end result is that many people regard LSD as
possibly causing genetic damage, since it hasn't been disproven. Once an
issue is raised concerning recreational drugs, it tends to linger, even if
there has never been good evidence to support it. Now, I agree that
we shouldn't assume anything is safe, but drugs with possible therapeutic
value (as LSD has been characterized) should be carefully explored (with an
eye out for possible negative effects) rather than dismissed on ultimately
flimsy grounds.
-!----------------------------------------------------------------------------
--------------
I'm including now just the 'summary' of this article in The Lancet, which is
the British JAMA, so to speak.
There are a few glitches in this beacuse of my scanning tchniques. I'll post
the whole artilce (just a couple of pages) soon.
-john
-!----------------------------------------------------
The Lancet, December 16, 1989
page 1440
Teratology
BIAS AGAINST THE NULL HYPOTHESIS: THE REPRODUCTIVE HAZARDS OF COCAINE
GIDEON KOREN
KAREN GR~A.N
HEATHER SHEAR
TOM EIXARSON
Motherisk Programme, Department of Pediatrics, Division of
Clinical Pharmacology; Research Institute and ???? of
Pharmacology; and Departments of Pediatrics and
Pharmacology, University of Toronto, Toronto, Ontano,
Canada
Summary
To examine whether studies showing no
adverse effects of cocaine in pregnancy
have a different likelihood of being accepted for presentation
by a large scientific meeting, all abstracts submitted to the
Society of Pediatric Research between 1980 and 1989 there
analysed. There were 58 abstracts on fetal outcome after
gestational exposure to cocaine. Of the 9 negative abstracts
(showing no adverse effect) only 1 (11%) was accepted,
whereas 28 of the 49 positive abstracts were accepted (57%).
This difference was significant. Negative studies tended to
verify cocaine use more often and to have more cocaine and
control cases. Of the 8 rejected negative studies and the 21
rejected positive studies, significantly more negative studies
verified cocaine use, and predominantly reported cocaine
use rather than use of other drugs. This bias against the null
hypothesis may lead to distorted estimation of the
teratogenic risk of cocaine and thus cause women to
terminate their pregnancy unjustifiably.
-!----------------------------------------------------------------------------
----------
>My question, then, is this: if you are for the legalization of all drugs,
>what is your answer to the question "What about crack babies?"
"Crack babies", inasmuch as they exist, are the same old babies who were
categorized as "Fetal Alcohol Syndrome" babies before cocaine became
popular. It turns out that if you exclude mothers who use other drugs,
babies born to cocaine users are just as healthy as those born to nonusers.
Alcohol, tobacco, neglect, and general poor health that goes with poverty
are the real causes of the cocaine syndrome politicians talk about so much.
But could they ever blame the legal megadrugs? Noooooo; that would be
political suicide.
Here's a new article on "crack babies" from _Science_News_, Nov 9,
1991. Clip and save!
***************************************************************
"Smoking out cocaine's _in_utero_ impact"
Despite many reports of cocaine's ill effects on the developing
fetus, scientists lack definitive evidence specifically linking
cocaine to adverse reproductive effects (SN: 9/7/91, p.152).
Using a powerful statistical technique, a Canadian research
team has found that cocaine by itself causes very few problems
during pregnancy.
Gideon Koren of the University of Toronto and his colleagues
identified 20 previously published cocaine studies that in-
volved pregnant women and yielded mixed results. Those
studies often relied on small samples of cocaine users -- a
problem that limited each study's statistical power.
To home in on cocaine's reproductive risks, his team turned
to a method called meta-analysis, which statisticians use to
assess data by pooling a number of similar studies. Koren and
his colleagues identified women in the 20 studies who used
cocaine during pregnancy but did not use other illicit drugs or
alcohol, and compared them with those who reported no drug
or alcohol use during pregnancy. They found no statistical link
between prenatal cocaine use and premature delivery, low
birthweight or congenital heart defects in babies -- problems
often thought to result from cocaine.
The meta-analysis suggests that confounding factors -- such
as other drugs, alcohol and smoking -- may account for the fetal
growth retardation or prematurity commonly ascribed to
cocaine, the researchers assert in the October _TERATOLOGY_.
Koren says women who use cocaine tend to smoke more
cigarettes than women who use other illicit drugs and are more
likely to drink alcohol and take additional drugs.
-!----------------------------------------------------------------------------
-------
This was sent to me from an anonymous post -- I didn't type it in.
(From _The Boston Sunday Globe_ * January 12, 1992, pg 69)
(Permission to reproduce this article has not been sought)
THE MYTH OF THE `CRACK BABIES'
By Ellen Goodman
They are called "a biological underclass" and "a lost generation."
Those are just two of the milder name tags attached to the children we
have come to believe were permanently damaged by their mothers' use
of cocaine.
The poster in maternity clinics conjure up the same image of the
prenatally doomed: "Some people who smoke crack never get over it."
The schools too have been put on emergency alert: "The crack babies are
coming, the crack babies are coming."
Indeed, the phrases "crack babies" and "crack kids" are shorthand for
monster-children who are born addicted. These are the kids destined to
grow up without the ability to pay attention or to learn or to love.
But just when the name has stuck, it turns out that "crack baby" may be
a creature of the imagination as much as medicine, a syndrome seen in
the media more often than medicine.
Three years after the epidemic of stories about these children began,
six years after hospitals began to see newborns in deep trouble,
researchers are casting doubt on the popular demon of the war on drugs.
The very phrase "crack baby" is, in any literal sense, a misnomer.
Cocaine is rarely taken by itself. It's part of a stew of substances
taken in a variety of doses and circumstances. No direct line has been
drawn from the mother's use of cocaine to fetal damage.
Alcohol and tobacco may do as much harm to the fetus as cocaine. So
may poor nutrition, sexually transmitted diseases, and the lack of
medical care. Most important, it appears that the children born to
cocaine-using mothers are not hopeless cases, permanently assigned to
the monster track. Dr. Ira Chasnoff, who did some of the original work
identifying the problem babies of mothers who took cocaine in
combination with other drugs, has done a two-year follow-up study about
to be published. It says, in his words, "Their average developmental
functioning level is normal. They are no different from other children
growing up. They are not the retarded imbeciles people talk about.
This is not, he cautions, a green light for taking drugs during
pregnancy. Drugs remain a serious health problem, and cocaine
specifically contributes to premature birth and small head size. While
the children in his study - children who have been offered some help -
now function normally as a group, they are at risk individually.
But, says Dr. Chasnoff, "As I study the problem more and more, I think
the placenta does a better job of protecting the child than we do as a
society." The need now is to widen the lens from nature to nurture, and
from the environment of the unborn to that of the born.
Another researcher who has taken a responsible second look at the
"crack baby" syndrome is Claire Coles of Emory University. She
believes these children, labeled by their drug of origin, are in fact
"often victims of gross neglect, not brain damage."
The worst damage that drugs may do is to the world a child inhabits
after birth. Coles has a collection of horror stories about children
growing up neglected, especially by cocaine addicts. One "crack kid"
who couldn't concentrate in class was in fact hungry. Another poorly
developed "crack baby" was being "raised" by a 5-year-old sister.
The myth of the "crack baby" became a media hit, Coles believes,
because "crack is exotic and happening mostly in `marginal' populations
among `bad people' who are not like `us.'" It is easier to think about
crack than alcohol or tobacco. There is more than a touch of racism in
the attention.
But perhaps the worst effect of this distortion is the sense of
hopelessness dispensed with the title "crack kid." Hopelessness on the
part of mothers, teachers, and even the children themselves. As Coles
warns, "If a child comes to kindergarten with that label, they're dead.
They are very likely to fulfill the worst prophecies."
So, no more convenient and empty names. The children whose mothers
used cocaine are neither universally nor permanently nor uniquely
damaged. The so-called "crack kids" are just a portion of our growing
population of children in deep trouble. They are only children, like
so many others, growing up with a treacherous mix of nature's and
nurture's woes.
If you need a label, call them kids who need help.
- Ellen Goodman is a Globe columnist.
-!---------------------------------
here's some abstracts on the subject..
2
AU - Koren G
AU - Graham K
AU - Shear H
AU - Einarson T
TI - Bias against the null hypothesis: the reproductive hazards of cocaine
[see comments]
AB - To examine whether studies showing no adverse effects of cocaine in
pregnancy have a different likelihood of being accepted for
presentation by a large scientific meeting, all abstracts submitted
to the Society of Pediatric Research between 1980 and 1989 were
analysed. There were 58 abstracts on fetal outcome after gestational
exposure to cocaine. Of the 9 negative abstracts (showing no adverse
effect) only 1 (11%) was accepted, whereas 28 of the 49 positive
abstracts were accepted (57%). This difference was significant.
Negative studies tended to verify cocaine use more often and to have
more cocaine and control cases. Of the 8 rejected negative studies
and the 21 rejected positive studies, significantly more negative
studies verified cocaine use, and predominantly reported cocaine use
rather than use of other drugs. This bias against the null hypothesis
may lead to distorted estimation of the teratogenic risk of cocaine
and thus cause women to terminate their pregnancy unjustifiably.
AD - Department of Pediatrics
AD - University of Toronto
AD - Ontario
AD - Canada.
SO - Lancet 1989 Dec 16;2(8677):1440-2
DP - 1989 Dec 16
TA - Lancet
PG - 1440-2
IP - 8677
VI - 2
UI - 90081155
3
AU - Lutiger B
AU - Graham K
AU - Einarson TR
AU - Koren G
TI - Relationship between gestational cocaine use and pregnancy outcome: a
meta-analysis.
AB - Despite a growing number of studies that have investigated the
reproductive effects of maternal cocaine use, a homogeneous pattern
of fetal effects has not been established and there is little
consensus on the adverse effects of the drug. We used meta-analysis
to evaluate the reproductive risks of cocaine. We reviewed the 45
scientific papers published in the English language dealing with
effects of cocaine used during pregnancy on pregnancy outcome in
humans, and identified 20 papers eligible for meta-analysis (cocaine
use in pregnancy, pregnancy/fetal outcome studies, human studies,
original work, cohort or case control studies, control group present,
English language). Our analysis revealed that very few adverse
reproductive effects could be shown to be significantly associated
with cocaine use by polydrug users when compared to control groups of
polydrug users not using cocaine [genitourinary malformations; odds
ratio of 6.08 (95% CI 1.18-31.3); gestation age: Cohen's d 0.37 (CI
0.2-0.55)]. When the control groups consisted of no drug users, the
polydrug users abusing cocaine had a higher risk for spontaneous
abortions [odds ration 10.50 (CI 11.74-64.1)]. Similarly, comparison
of users of cocaine alone or no drug users revealed a higher risk for
in utero death, in addition to genitourinary tract malformations.
Analysis of continuous variables (head circumference, gestational
age, birth weight and length) revealed that the effect size was
dependent upon the nature of the comparison. Comparison of cocaine
users to no drug users consistently yielded a medium effect size
(Cohen's d) between 0.50 and 0.58, while comparison of
polydrug/cocaine users to polydrug/no cocaine users provided effect
sizes small to non existent (0.06-0.37). These discrepancies suggest
that a variety of adverse reproductive effects commonly quoted to be
associated with maternal use of cocaine may be caused by confounding
factors clustering in cocaine users.
AD - Department of Pediatrics
AD - Hospital for Sick Children Toronto
AD - Ontario
AD - Canada.
SO - Teratology 1991 Oct;44(4):405-14
DP - 1991 Oct
TA - Teratology
PG - 405-14
IP - 4
VI - 44
UI - 92074030
4
AU - Chasnoff IJ
AU - Griffith DR
AU - Freier C
AU - Murray J
TI - Cocaine/polydrug use in pregnancy: two-year follow-up [see comments]
AB - The impact of cocaine on pregnancy and neonatal outcome has been well
documented over the past few years, but little information regarding
long-term outcome of the passively exposed infants has been
available. In the present study, the 2-year growth and developmental
outcome for three groups of infants is presented: group 1 infants
exposed to cocaine and usually marijuana and/or alcohol (n = 106),
group 2 infants exposed to marijuana and/or alcohol but no cocaine (n
= 45), and group 3 infants exposed to no drugs during pregnancy. All
three groups were similar in racial and demographic characteristics
and received prenatal care through a comprehensive drug treatment and
follow-up program for addicted pregnant women and their infants. The
group 1 infants demonstrated significant decreases in birth weight,
length, and head circumference, but by a year of age had caught up in
mean length and weight compared with control infants. The group 2
infants exhibited only decreased head circumference at birth. Head
size in the two drug-exposed groups remained significantly smaller
than in control infants through 2 years of age. On the Bayley Scales
of Infant Development, mean developmental scores of the two groups of
drug-exposed infants did not vary significantly from the control
group, although an increased proportion of group 1 and 2 infants
scored greater than two standard deviations below the standardized
mean score on both the Mental Developmental Index and the Psychomotor
Developmental Index compared with the control infants. Cocaine
exposure was found to be the single best predictor of head
circumference.(ABSTRACT TRUNCATED AT 250 WORDS)
AD - Department of Pediatrics
AD - Northwestern University Medical School
AD - Chicago
AD - IL.
SO - Pediatrics 1992 Feb;89(2):284-9
DP - 1992 Feb
TA - Pediatrics
PG - 284-9
IP - 2
VI - 89
UI - 92131597
5
AU - Graham K
AU - Dimitrakoudis D
AU - Pellegrini E
AU - Koren G
TI - Pregnancy outcome following first trimester exposure to cocaine in
social users in Toronto, Canada.
AB - Studies of drug-dependent women reveal high rates of adverse fetal
effects of cocaine. However, no data are available on the effect of
the chemical in social users who discontinue cocaine upon realizing
they are pregnant. We report the results of the first phase of a
prospective study examining the outcome of pregnancy in women seeking
counseling from the Motherisk Program in Toronto. Of 25 women seen in
our clinic for 1st trimester cocaine exposure, 92% reported use of
less than 10 g of cocaine and 36% reported marijuana use. Other
illicit drug use was rare; cigarette and alcohol use was common. The
study group did not experience adverse pregnancy outcome above the
rate expected in the general population. There were 23 single births
1 pair of twins, and 1 spontaneous abortion. Birth weight and
gestation were within normal limits. Only 1 child had a major
malformation, syndactyly. Infant development was within normal
limits, as measured by developmental milestones. All children are
scheduled for assessment using the Bayley Scales of Infant
Development. The results of the BSID will be compared to results from
a cannabis-exposed control group and a no-drug control group.
AD - Division of Clinical Pharmacology and Toxicology
AD - Research Institute
AD - Toronto
AD - Ontario
AD - Canada.
SO - Vet Hum Toxicol 1989 Apr;31(2):143-8
DP - 1989 Apr
TA - Vet Hum Toxicol
PG - 143-8
IP - 2
VI - 31
UI - 89188370
1
AU - Coles CD
AU - Platzman KA
AU - Smith I
AU - James ME
AU - Falek A
TI - Effects of cocaine and alcohol use in pregnancy on neonatal growth
and neurobehavioral status.
AB - Effects on fetal growth and neonatal behavior of cocaine and alcohol
use in pregnancy were investigated in infants born to women in a low-
income, predominantly black population. Despite the increased use of
cocaine by pregnant women and the accompanying public concern,
behavioral studies of exposed neonates are limited in number and
scope. In most studies, confounding factors (e.g., polydrug abuse,
prematurity, infant health status) have not been controlled so the
actual effects of cocaine and other drug exposure are not clear.
Accordingly, this study investigated effects of prenatal drug
exposure although controlling experimentally for other factors known
to be associated with poor outcomes in infants: prematurity, other
illicit drug use, associated diseases (e.g., sexually transmitted
diseases [STDs]), and duration of drug use. In addition, other
factors statistically controlled were: experimenter effects, timing
of assessment, and effects of duration, amount, and frequency of
cocaine, alcohol, marijuana, and nicotine exposure. One hundred and
seven full-term infants were assessed at 2, 14, and 28 days using the
Brazelton Neonatal Behavioral Assessment Scale (BNBAS) by testers
blind to infant status. Growth factors (i.e., birthweight, length,
head circumference) were also assessed.
AD - Department of Psychiatry
AD - Emory University School of Medicine
AD - Atlanta
AD - GA.
SO - Neurotoxicol Teratol 1992 Jan-Feb;14(1):23-33
DP - 1992 Jan-Feb
TA - Neurotoxicol Teratol
PG - 23-33
IP - 1
VI - 14
UI - 92278270
2
AU - Richardson GA
AU - Day NL
TI - Maternal and neonatal effects of moderate cocaine use during
pregnancy.
AB - Thirty-four women who reported using cocaine during pregnancy were
compared to 600 women who reported no cocaine use during pregnancy
and none for the year prior to pregnancy. Subjects were participants
in a prospective, longitudinal study of prenatal substance use. The
sample consisted of young, predominantly single, low-income women
attending a public prenatal clinic. Women were interviewed at the end
of their first, second and third trimesters regarding cocaine,
alcohol, marijuana, tobacco and other drug use. The majority of the
cocaine users were light to moderate users who decreased their use
during pregnancy. The cocaine group was more likely to be white and
to use alcohol, marijuana, tobacco and other illicit drugs more
heavily than the comparison group. The cocaine users had more
previous fetal losses but did not differ on other obstetrical
complications. Infant growth, morphology and behavior were not
affected.
AD - Western Psychiatric Institute and Clinic
AD - University of Pittsburgh
AD - PA 15213.
SO - Neurotoxicol Teratol 1991 Jul-Aug;13(4):455-60
DP - 1991 Jul-Aug
TA - Neurotoxicol Teratol
PG - 455-60
IP - 4
VI - 13
UI - 92017483
1
AU - Graham K
AU - Feigenbaum A
AU - Pastuszak A
AU - Nulman I
AU - Weksberg R
AU - Einarson T
AU - Goldberg S
AU - Ashby S
AU - Koren G
TI - Pregnancy outcome and infant development following gestational
cocaine use by social cocaine users in Toronto, Canada.
AB - To determine the effect of first trimester cocaine use on pregnancy
outcome we conducted a prospective cohort study of 30 women admitting
to social cocaine use (SCU) during early pregnancy, 20 users of
cannabis during the first trimester and 30 matched recreational drug-
free control subjects. The groups were of similar age, marital
status, and obstetric history and were predominantly white. They were
of similar socioeconomic status (SES), however the spouses of the
cocaine users were of significantly lower SES than those of both
control groups (p less than 0.005). The number of years of education
of the cocaine users and the fathers of the SCU-exposed fetuses was
significantly lower than that of the recreational drug-free control
subjects (p = 0.004), however, female IQ was similar among the three
groups (109.1 +/- 12.4 cocaine; 109.1 +/- 25.2 cannabis; 114.1 +/-
11.7 drug-free). Alcohol and cigarette use was greater among the
cocaine users than among subjects of the recreational drug-free
control group (p less than 0.025). Cocaine and the associated
lifestyle were not associated with any adverse obstetric or neonatal
endpoint (pregnancy weight gain, incidence of delivery complications,
gestational age, birth weight, Apgar scores, and rates of major and
minor malformations). There were no differences between groups in
attaining developmental milestones. Mental and motor scores on the
Bayley Scales of Infant Development and Vineland Adaptive Behavior
Scales were identical among the three groups, studied at a mean of
19.7 months of age. We conclude that outcome of pregnancy of social
cocaine users and subsequent infant physical and cognitive
development are within normal limits at 1.6 years of age.
AD - Department of Pediatrics
AD - Hospital for Sick Children
AD - Toronto
AD - Ontario.
SO - Clin Invest Med 1992 Aug;15(4):384-94
DP - 1992 Aug
TA - Clin Invest Med
PG - 384-94
IP - 4
VI - 15
UI - 92386817
2
AU - Koren G
AU - Graham K
TI - Cocaine in pregnancy: analysis of fetal risk.
AB - During the last decades there has been a substantial increase in the
recreational use of cocaine in young adults and parallelly there has
been an increase of its use by pregnant women. We analyzed all
published papers on cocaine use in pregnancy and found that for most
endpoints studied (eg, prematurity, head circumference) there were
many studies showing effects and many showing no effects. Upon meta-
analysis, most of these effects could not be shown significant when
compared to control groups. In a prospective study in Toronto, babies
exposed to cocaine during the first trimester only had Bayley scores
at 18-mo of life that were identical to unexposed babies or to those
exposed to canabinoids. Motherisk presently counsels women who
discontinue cocaine use in the first trimester of pregnancy that
there is no increased developmental risk for the baby.
AD - Department of Pediatrics & Research Institute
AD - Hospital for Sick Children
AD - Toronto
AD - Ontario
AD - Canada.
SO - Vet Hum Toxicol 1992 Jun;34(3):263-4
DP - 1992 Jun
TA - Vet Hum Toxicol
PG - 263-4
IP - 3
VI - 34
UI - 92303120
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This is from http://www.mojones.com/mother_jones/JA95/greider.html:
The MoJo Wire mother_jones [LINK] news_wire coinop_congress
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CRACKPOT IDEAS
The "crack-baby" scare filled the conservatives' need for scapegoats,
the liberals' need for program funding, and the media's need for
headlines. So what if it wasn't true?
by Katharine Greider
* Hale's Children
* Daniel in the Lion's Den
During the late '80s, Americans shook their heads in disgust at
reports that poor black mothers were sacrificing the little ones
resting in their wombs for the pleasures of crack cocaine, callously
dooming a new generation to "a life of certain suffering, of probable
deviance, of permanent inferiority," to quote columnist Charles
Krauthammer.
Seizing on early studies that raised alarm over fetal damage from
cocaine, scientists cited the same inconclusive data again and again.
Local news organs spun their own versions of the crack-baby story,
taking for granted the accuracy of its premise. Social workers, foster
parents, doctors, teachers, and journalists put forward unsettling
anecdotes about the "crack babies" they had seen, all participating in
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