Cocaine mothers imperil babies' brains.

Cocaine mothers imperil babies' brains

Babies born to women who used cocaine during their first trimester of pregnancy may suffer subtle neurological damage, a finding that raises questions about whether these children will develop learning disabilities later in life. The study marks the first time scientists have studied the effects of cocaine use during the initial months of pregnancy.

A related report confirms that women who used cocaine and/or marijuana during pregnancy run an increased risk of having underweight babies. Compared with newborns of normal weight, tiny infants have a greater risk of medical problems and death.

In the first report, Ira J. Chasnoff and his colleagues at the Northwestern University Medical School in Chicago studied the infants of 23 women who stopped using cocaine during the first trimester, 52 women who used the drug throughout pregnancy and 40 women with ho history or evidence of drug abuse. The researchers questioned the women about drug use and gave them drug tests once a week.

Examiners gave newborns the Neonatal Behavioral Assessment Scale, a test that picks up neurologically related behavioral difficulties such as the inability to remain alert. Cocaine-exposed infants scored poorly on the test compared with unexposed babies, the researchers report in the March 24/31 JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. These infants had attention and orientation problems and were less likely to respond to a human voice or face, Chasnoff says.

"Even if the woman stops using cocaine during the first trimester, the baby still has neurological damage," Chasnoff says. "Women of childbearing age should not be using cocaine."

The National Institute on Drug Abuse estimates that 14 percent of women age 15 to 44 have tried cocaine at least once.

Doctors may not recognize the subtle behavioral problems of cocaine-exposed newborns, Chasnoff says. "Cocaine-exposed infants are either very irritable or they become so overwhelmed that they shut down and go into a deep sleep," Chasnoff says. These traits in infants may make it difficult for some mothers to provide the human interaction that is an important part of the learning process, he says.

In the second report, Barry Zuckerman of the Boston University School of Medicine and his colleagues studied 1,226 new mothers and found that 27 percent used marijuana sometime during pregnancy and 18 percent used cocaine. The researchers relied on interviews and drug tests to determine drug use.

Infants exposed to marijuana weighed an average of 79 grams less and were 0.5 centimeter shorter than babies born to women who had not used drugs, the researchers report in the March 23 NEW ENGLAND JOURNAL OF MEDICINE. Babies born to women who used cocaine weighed 93 grams less and were 0.7 centimeter shorter than control infants. That finding mirrors results seen in the Chicago study. In addition, Chasnoff's team found that women who used cocaine throughout pregnancy had smaller babies than did controls or women who stopped using cocaine early in pregnancy.

Both reports suggest pregnant women should not use drugs -- advice addicted women may find hard to follow. "We have to develop ways of helping people cope with stress in some other way," Zuckerman says.