Prenatal Cocaine Exposure: Long‐Run Effects and Policy Implications

Abstract

In this article, we review the literature regarding prenatal cocaine exposure and child development. We then reexamine current child welfare policies in light of that literature, paying particular attention to laws that mandate reporting substance-exposed newborns and substance use during pregnancy as well as policies that view such reports as prima facie evidence of child maltreatment. Finally, we reassess the utility of such policies, given our current knowledge of the long-term effects of prenatal exposure, and consider alternative approaches to protecting children who are born to parents who are using crack cocaine.

Developmental and behavioral consequences of prenatal cocaine exposure: a review

“…Continued research in conjunction with multivariate statistical techniques will help researchers examine longitudinal trajectories, mediating or moderating factors and to statistically control for many of the prenatal and postnatal variables known to influence long-term outcomes in this population. Given the large number of exposed children in the child welfare system (for example, foster care) as well as the increased need for medical, mental health and special education services within this population, 114 more definitively documenting associations between PCE and later developmental and behavioral outcomes is essential in order to be able to prospectively address the many significant public health, economic and public policy implications.…”

“…The lack of consistent methodological approaches across studies of PCE likely contributes to much of this inconsistency. 25,114,115 For example, a large proportion of study cohorts consist of low-SES, urban, ethnic minority participants. This limits the generalizability of study findings to a more diverse population.…”

Risk and Protective Factors Contributing to the Longitudinal Psychosocial Well-Being of Adopted Foster Children

“…Contrary to the notion that was common during the 1980s that "crack babies" had dismal futures, some research has suggested that crackexposed children with bleak early lives may indeed catch up developmentally and overcome their cognitive and behavioral deficits (Berger & Waldfogel, 2000).…”

“…Conversely, additional research in this area has yielded conflicting findings, particularly with respect to crack cocaine exposure (Berger & Waldfogel, 2000;Morrison, Cerles, Montaini-Klovdahl, & Skowron, et al, 2000). Contrary to the notion that was common during the 1980s that "crack babies" had dismal futures, some research has suggested that crackexposed children with bleak early lives may indeed catch up developmentally and overcome their cognitive and behavioral deficits (Berger & Waldfogel, 2000).…”

Risk Factors Associated with Alcohol, Cigarette, and Illicit Drug Use Among Pregnant Women

“…According to the American Hospital Association (1990), it is frequently a medical emergency, rather than routine prenatal care, that brings these women in contact with the health care system. Beyond the adverse health effects experienced by substance-using women (e.g., hypertension, anemia, adult onset diabetes, HIV/AIDS, other sexually transmitted diseases), there are the biological vulnerabilities faced by their children that include a variety of cognitive, behavioral, and emotional deficits directly related to prenatal drug exposure (Berger & Waldfogel, 2000;Zuckerman & Frank, 1992). Unfortunately, these negative consequences do not stop at birth where the lives of these children are further complicated by chaotic and violent home environments, inadequate caregiving, and multiple foster care placements (GAO, 1997;Pollack et al, 2002).…”