Effects of Intrauterine Exposure to Alkaloidal Cocaine ('Crack')

Sir.—The dramatic increase in the use of alkaloidal cocaine ("crack") during Pregnancy has led to a growing concern about its effect on exposed [ill]etuses.^1-3 Since crack vaporizes at relatively low temperatures, it can be smoked, with a large quantity of the drug absorbed by the pulmonary vasculature. This leads to a rapid onset of [ill]uphoria, which disappears in about 30 minutes. The repeated use of crack to [ill]egain the euphoric state leads to a [ill]igh level of fetal exposure. Cocaine [ill]as a profound effect on catecholamine metabolism and cardiovascular func[ill]ion,⁴ and the exposed fetus may be [ill]laced in jeopardy for both short- and [ill]ong-term adverse effects.

Patients and Methods.—This report rep[ill]esents a preliminary study in which we describe the clinical findings observed in 38 infants (21 male, 17 female) of crack-abus[ill]ng mothers who were admitted to our [ill]pecial-care nursery over a four-month pe[ill]iod. All the mothers denied