Cocaine babies: Better than we feared, not as unscathed as we hoped

In the mid 1980s, when the cocaine epidemic was at its height, frightening headlines warned of the devastating effects of maternal cocaine use on babies: Developmental defects were going to be common, and schools would be overwhelmed by the special needs of these "cocaine babies" when waves of them arrived for class. Happily, those fears proved largely unfounded. Developmental disabilities were not unusually frequent among these children, and difficulties that the children did have could be largely counteracted by a supportive home environment.

Now, a 13-year study that compares a group of Florida infants exposed to cocaine in utero with a group that was not exposed is beginning to show "subtle" developmental differences in some of the exposed children. Researchers found that, at birth, prenatal exposure was linked both to smaller head circumference and less-than-optimal home environment. At 7 years of age, neurodevelopmental and intelligence tests revealed small but discernible differences in the cocaine-exposed children's ability to plan and to solve problems. The quality of the home environment, researchers found, was more likely than smaller head size to influence outcome.

According to Deborah A. Frank, MD, professor of pediatrics at Boston University, the University of Florida study will "do much to dispel the inaccurate and hysterical predictions that stigmatize children with intrauterine cocaine exposure...." The children in the study are now entering their pre-teen years, when, Dr. Frank points out, long-term follow-up will be crucial to monitor for sleeper effects that may emerge in adolescence.