Effects of Prenatal Cocaine on Hearing, Vision, Growth, and Behavior^a

Abstract

The illicit use of cocaine has increased dramatically over the last 10-12 years. There has been a corresponding increase in cocaine abuse among obstetric patients and in the number of "cocaine babies." According to some estimates, these children make up more than half of the drug-associated births. This problem is therefore a major public health concern. Consequently, our laboratory investigated the effects of prenatal cocaine exposure on hearing, vision, growth, and exploratory/stress behavior. This chapter summarizes the literature on animals and humans on these topics and presents new observations from our laboratory. In terms of maternal toxicity, prenatal cocaine exposure causes hypertension, placental abruption, spontaneous abortion, poor pregnancy weight gain, and undernutrition secondary to appetite suppression. Some offspring effects include in utero growth retardation, cephalic hemorrhage, fetal edema, altered body composition, congenital malformations, and even pre- and postnatal death. The offspring can also exhibit a variety of behavioral, visual, hearing, and language disorders. Differential effects of animal strain and late gestational cocaine exposure are discussed. Comparisons are made between prenatal cocaine, the fetal alcohol syndrome, and the effects of prenatal undernutrition. Recommendations for clinical assessment and intervention are made.

Risky Health Behaviors Among Mothers-to-Be: The Impact of Adverse Childhood Experiences

“…For women of childbearing age, alcohol and illicit drug use may impact the women directly, but also have significant impact on their children directly during fetal life and after birth. In utero exposure to alcohol or illicit drugs is associated with congenital defects, intrauterine growth retardation, low birthweight, preterm birth, cognitive deficits, and behavioral problems 20, 21. Increasingly, policy makers and investigators, including the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the Centers for Disease Control and Prevention, are stressing the importance of addressing alcohol and drug use not only during pregnancy but also during the preconception period,22-27 because it is often too late to counsel against these risk factors and their teratogenic effects by the time women seek prenatal care 26.…”

Severity of Prenatal Cocaine Exposure and Child Language Functioning Through Age Seven Years: A Longitudinal Latent Growth Curve Analysis

“…Cocaine may affect language development through alterations in the developing monoaminergic neurotransmitter systems (Mayes, 1994(Mayes, , 1999 and through indirect pathways related to cocaine-associated maternal hypertension, decreased uterine blood flow, fetal vasoconstriction and hypoxemia (Mayes, 1994;Moore et al, 1986;Volpe, 1992;Zuckerman and Frank, 1992b) and nutritional deficiencies (Church et al, 1998;Frank et al, 1990;Jacobson et al, 1994;Zuckerman et al, 1989).…”

Intrauterine Growth of Full-Term Infants: Impact of Prenatal Cocaine Exposure

“…6 In these studies, there is also an observed dose-dependent suppression of maternal weight gain and food consumption. The authors suggest that the reduction in fetal protein and body fat content results from reduced synthesis secondary to decreased placental transport of fatty acids and amino acids.…”

“…A large body of evidence has been published indicating that in utero cocaine exposure is associated with modest to moderate deficits in fetal growth. Evidence is drawn from animal models, 6 clinical studies of human neonates as reviewed elsewhere, 7-10 and meta-analyses. 11,12 This report provides an introduction to the study design of the Miami Prenatal Cocaine Study (PCS), a longitudinal investigation of the effects of in utero cocaine exposure in a sample of full-term, inner-city African-American neonates enrolled at birth.…”