'Crack Baby' Theory Doubted 

'Crack Baby' Theory Doubted 
Posted by FoM on March 27, 2001 at 21:08:32 PT
By David Brown, Washington Post Staff Writer
Source: Washington Post
Infants and toddlers whose mothers used cocaine during pregnancy don't seem to have brain abnormalities or developmental problems attributable to the drug, according to a new analysis of research done over the last decade.The study disputes the stereotype of the "crack baby" -- a pathetic, permanently damaged person unlikely to live a normal life. It does not, however, absolve cocaine of any damaging effect during pregnancy, or declare the drug safe for expectant mothers.
"There is no need to assume that cocaine-exposed babies are a doomed generation or a biologic underclass, which is what was said about them initially," said Deborah A. Frank, a pediatrician at the Boston University School of Public Health. "The idea that these children are uniquely 'unteachable' or somehow out of control is simply not supported by the data."Writing in today's Journal of the American Medical Association, the researchers concluded that many developmental abnormalities attributed to cocaine exposure "can be explained in whole or in part by other factors, including prenatal exposure to tobacco, marijuana, or alcohol, and the quality of the child's environment."The conclusions are valid only for children up to age 6 because longer-range evaluations are not finished. The National Institute on Drug Abuse, a branch of the National Institutes of Health, is following 14 groups of cocaine-exposed children."There are some subtle developmental outcomes that many laboratories are beginning to see as children get close to adolescence," said Alan I. Leshner, director of NIDA. "We need to be careful not to fall prey to a false sense of security."Frank and her colleagues looked at 36 studies in which drug tests were given to women during pregnancy, or to their babies at birth. The children's development was then followed over time.Many of the women used numerous drugs, including legal ones such as tobacco and alcohol, and many had other risk factors for delivering unhealthy babies, including poor diet, lack of prenatal care and poverty.With so many variables at work, discerning cocaine's contribution to bad outcomes has been difficult. Most of the 36 studies -- all published previously -- tried to do that. What the researchers did was look at them together to determine a trend.As a generality, the studies found that when a woman used alcohol and tobacco, or alcohol and marijuana, cocaine use had little or no "incremental impact" on her child's risk of problems after birth.Specifically, cocaine had no lasting effect on physical growth; it generally did not affect the cognitive ability of infants or young children; it did not affect language skills (although few studies looked at this question); and a deleterious effect on motor skills that some researchers had found seemed not to extend beyond the first six months of life.The most difficult area to assess was cocaine's possible effects on social behavior, mood and attention. Several studies found that cocaine-exposed children showed less joy, sadness or interest in learning tasks. Overall, though, children of cocaine-using mothers have no clear-cut behavioral problems.Only some of the studies compared women who used cocaine (and other drugs) with women who used no drugs. Consequently, it's not possible to conclude that cocaine confers no risk -- only that its effects are similar, and not more severe, than other known risks to infants.Previous research has shown that cocaine use raises the chances that a baby will be born prematurely, or will have a low birthweight, twofold to fourfold. Preterm birth and low birthweight also are risks for developmental problems.In recent years, prosecutors in many states have tried to detain, forcibly treat or punish pregnant women found to be taking illegal drugs. In most cases, the women were compulsive users of crack cocaine.In 22 states where the charges were challenged, courts have ruled in favor of the women. Last week the Supreme Court ruled that a South Carolina hospital overstepped its bounds in 1989 when it tested the urine of pregnant women for drugs and forwarded the results to police. Thirty women were arrested under that program, which was abandoned in 1994.David S. Cohen, a lawyer with the Women's Law Project in Philadelphia, said most attempts to treat drug use during pregnancy as a crime occurred in the early 1990s "in direct response to the original hype of the so-called 'crack baby.' "While such actions are rare today, "we still occasionally hear of prosecutions of pregnant women around the country," he said.The authors of the new study mention by name CRACK, an organization in Southern California whose name stands for Children Requiring A Caring Kommunity. Since late 1997, it has paid 389 drug-using women to take long-term birth control, or undergo sterilization.Barbara Harris, 48, CRACK's leader and the adoptive mother of four children of a drug-addicted woman, said the study will alter "not at all" the organization's campaign. She noted that the 389 women, most of whom used crack, had a total of 146 stillborn infants and 47 who died from complications after birth.Note: Study: Effect of Mother's Drug Use Less Severe Than Thought. Source: Washington Post (DC) Author: David Brown, Washington Post Staff WriterPublished: Wednesday, March 28, 2001; Page A04 Address: 1150 15th Street Northwest, Washington, DC 20071Copyright: 2001 The Washington Post Company Contact: letterstoed washpost.comWebsite: Related Articles:Court Nixes Hospital Drug Tests Abuse - MoJo Wire Babies and Rights
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