The effects of intrauterine cocaine exposure in newborns.

Objectives: We sought to determine the effects of intrauterine cocaine exposure in newborns, in an inner-city population in which cocaine use during pregnancy was common.

Methods: During a 1-year period, 12.8% (361 of 2810) of all live singleton infants at Harlem Hospital in New York were identified as cocaine exposed, either by universal urine toxicologic screening or by maternal history. Cocaine-exposed infants were compared with a control group of 387 infants not known to be exposed to cocaine or other illicit drugs.

Results: Low birthweight (< 2500 g) was more common among cocaine-exposed infants (31% vs 10%), as was preterm birth (< 37 completed weeks of gestation) (32% vs 14%). In multivariate analyses controlled for demographic and life-style factors and duration of gestation, cocaine was associated with decreased birthweight (154 g), length (1.02 cm), head circumference (0.69 cm), and duration of gestation (0.74 weeks). The birthweight deficits were larger for infants born to mothers who used cocaine in combination with other drugs (195 g) and for infants born to mothers who specifically admitted using crack (200 g).

Conclusions: Intrauterine cocaine exposure is linked with fetal growth retardation and shortened gestation in this population.