NEW STUDY SHOWS BABIES EXPOSED TO COCAINE BEFORE BIRTH NOT SHOWING SEVERE
PROBLEMS THAT HAD BEEN ANTICIPATED

RENEE MONTAGNE, host: In this week's Journal of the American Medical
Association, researchers report that prenatal exposure to cocaine is not
associated with major adverse developmental effects in early
childhood. NPR's Michelle Trudeau reports.

MICHELLE TRUDEAU reporting:

Ever since the crack cocaine epidemic hit in the 1980s, scientists have
been monitoring the growth and development of infants exposed to cocaine in
the womb. Early reports predicted severe consequences for these so-called
crack babies of brain damage, growth retardation, behavioral disorders,
says developmental pediatrician Deborah Frank.

Dr. DEBORAH FRANK (Developmental Pediatrician): There was all this popular
mythology that these children were somehow doomed and unlovable and
unteachable and unadoptable and, quote, unquote, "biologic underclass."

TRUDEAU: But over the past decade, evidence has been mounting that cocaine
exposure may not be as devastating a biological injury as earlier
predicted. Frank and her research team from Boston University pooled all
the research going back to 1984 and critically evaluated it.

Dr. FRANK: We did not find any good evidence that prenatal cocaine exposure
had a bad effect on the children's physical growth up to age six, on their
developmental test scores, which is like IQ tests, receptive or expressive
language.

TRUDEAU: Frank cautions that this does not mean cocaine is harmless. It is
a drug that affects brain cells. But her analysis reveals that the effects
associated with prenatal cocaine exposure are not uniquely different in
severity or scope from those associated with other toxins, such as alcohol
and tobacco, which are known to be harmful to the developing fetus.

Dr. FRANK: Nobody is recommending that the people should use cocaine in
pregnancy and not worry about it any more than doctors recommend that
people should smoke cigarettes in pregnancy or drink alcohol and not worry
about it. All of those things are loading the dice against the mother and
the child, but they're all quite comparable.

TRUDEAU: In fact, Frank adds, many developmental problems originally
attributed to cocaine exposure may be the result of tobacco exposure.
Pediatric researcher Barry Lester from Brown University cautions, though,
that the research isn't yet done. The jury's still out on the long-term
effects of prenatal cocaine exposure.

Mr. BARRY LESTER (Brown University): What's missing is the whole very
logical possibility that maybe cocaine effects areas of the brain that we
don't see manifest until kids get older.

TRUDEAU: The studies so far, he points out, have tracked children only up
to age six, and behavioral problems such as attention deficit disorder or
poor impulse control may emerge later as children face tougher academic and
social challenges.

Mr. LESTER: And so to say that because we don't see negative effects early
on, the drug has no effect, when in fact, it could very well have an effect
when these kids get older, I just think the conclusions are premature.

TRUDEAU: That's why both Lester and Deborah Frank are continuing to study
these children as they progress through childhood into puberty. As for what
can be done now, providing women with greater access to drug and alcohol
treatment programs is still critical for a healthy pregnancy to lessen the
overwhelming odds many of these newborns will face, the vast majority being
born into poverty. With increased risk of malnutrition, exposure to
violence, poor early child care, these are the most powerful factors, say
the researchers, that shape a child's intellectual and emotional
growth. Cocaine, they add, is just one part of that milieu. Michelle
Trudeau, NPR News.

MONTAGNE: The time is 21 minutes before the hour.