title: Cocaine abuse during pregnancy.
abstract: Cocaine abuse during pregnancy is a significant public health problem but is infrequently discussed between physicians and patients. The impact of in utero cocaine exposure on pregnancy and the baby has received significant media attention in preceding decades because of fears of teratogenicity, long-term health consequences, and poor cognitive and neurodevelopmental outcomes. We sought to review the medical literature examining these phenomena. We identified risks to the pregnancy and baby in women abusing cocaine during pregnancy. These include preterm birth, placenta-associated syndromes (e.g., placental abruption, preeclampsia, and placental infarction), and impaired fetal growth. Long-term neurodevelopmental and cognitive deficits include (but are not limited to) poorer language development, learning and perceptual reasoning, behavioural problems, and adverse effects on memory and executive function. However, these results should be interpreted cautiously because cocaine abuse may be accompanied by many other maternal and sociodemographic risk factors, so it is difficult to ascertain the effect of cocaine alone. Therefore, it is critical to counsel patients about potential risk, and perhaps more importantly, to treat addiction and to better understand, and advocate for improvements to, these patients' high-risk environment.
authors.affiliation: Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto ON; Faculty of Medicine University of Toronto, Toronto ON.
authors.forename: Alex M
authors.initials: AM
authors.lastname: Cressman
authors.affiliation: Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto ON.
authors.forename: Aniket
authors.initials: A
authors.lastname: Natekar
authors.affiliation: Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto ON.
authors.forename: Eunji
authors.initials: E
authors.lastname: Kim
authors.affiliation: Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto ON; Faculty of Medicine University of Toronto, Toronto ON.
authors.forename: Gideon
authors.initials: G
authors.lastname: Koren
authors.affiliation: Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto ON.
authors.forename: Pina
authors.initials: P
authors.lastname: Bozzo
mesh_terms: D019970:Cocaine-Related Disorders / Q000150:complications; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications; D012307:Risk Factors
keywords: cocaine; pregnancy; teratogenicity