A "second generation" of medical and scientific studies has significantly advanced our knowledge of the postnatal consequences of fetal exposure to cocaine. Experiments involving both animals and humans have yielded a striking convergence of findings, indicating that higher levels of cocaine exposure alters programs for brain development in ways that may be associated with lasting changes in brain structure, neuronal function, and behavior. The "crack baby syndrome," in other words, is real, but the effects are more subtle than was previously thought.
In Cocaine: Effects on the Developing Brain John A. Harvey and Barry E. Kosofsky bring together a distinguished group of authorities to present a summary of these new findings. While stressing that no single factor independently determines a particular behavioral outcome, the authors present evidence that indicates a clear association of prenatal cocaine exposure with abnormalities ranging from such measurable physical attributes as decreased head size to more subtle behavioral deficits such as modulating attention, impulsivity, and responsiveness.
At a time when studies indicate that as many as 221,000 women use an illicit drug at least once during pregnancy, the authors set as a high priority ways of identifying which children and infants are at risk and what kinds of interventions are appropriate. General topics include maternal-fetal effects; postnatal effects; developmental mechanisms; functional deficits; longitudinal studies in humans; and public policy.
