Cocaine and development: mechanisms of fetal toxicity and neonatal consequences of prenatal cocaine exposure

• Published in: Early human development Vol. 31; no. 1; pp. 1 - 24
• Main Authors: Gingras, Jeannine L., Weese-Mayer, Debra E., Hume, Roderick F., O'Donnell, Karen J.
• Format: Journal Article
• Language: English
• Published: Lausanne Elsevier Ireland Ltd 01.11.1992; New York,NY Elsevier; Amsterdam
• Subjects: Animals; Biological and medical sciences; cocaine; Cocaine - pharmacology; Cocaine - toxicity; developmental injury; Diseases of mother, fetus and pregnancy; Female; Fetus - drug effects; Gynecology. Andrology. Obstetrics; Humans; in utero cocaine exposure; Infant, Newborn - physiology; Maternal-Fetal Exchange; Medical sciences; Mice; Nervous System - drug effects; Pregnancy; Pregnancy Complications; Pregnancy. Fetus. Placenta; prenatal cocaine exposure; Prenatal Exposure Delayed Effects; Rats; Respiration - drug effects; Substance-Related Disorders; developmental injury; cocaine; in utero cocaine exposure; prenatal cocaine exposure; Pregnancy; Human; Drug addiction; Newborn; Toxicity; Fetus; Cocaine; Maternal diseases
• ISSN: 0378-3782; 1872-6232
• DOI: 10.1016/0378-3782(92)90011-5

As cocaine use during pregnancy has become increasingly recognized, there also has been increased concern about the toxic and teratogenic properties of cocaine on the fetus. A significant literature exists describing the adverse fetal and neonatal outcomes associated with in utero cocaine exposure. However, specific causality by cocaine on outcome in the human is difficult to ascertain because of multiple confounding variables associated with substance abuse including social factors and polydrug use as well as difficulty in confirming timing, dose and frequency of cocaine exposure. Most literature suggests that prenatal cocaine exposure is associated with developmental risk to the fetus. What is currently unknown is the extent of risk, the additive and/or synergistic factors contributing to cocaine's toxicity and the reversibility of the injury. In this paper we review the pharmacologic properties of cocaine as related to a model of mechanisms for developmental injury secondary to cocaine exposure and the published literature on the adverse fetal and neonatal outcomes associated with cocaine use during pregnancy. Specific attention has been focused on the structural, neurobehavioral and respiratory control teratogenesis.