EFFECTS ON THE FETUS

• Cocaine easily crosses the placenta and the blood brain barrier.
• Theoretical model of the effects of prenatal cocaine exposure on child behavior:
     o Cocaine affects neuroregulatory mechanisms, which in turn result in disorders of behavioral regulation.
     o These disorders of behavioral regulation are manifest as the "Four A's of Infancy" attention, arousal, affect, and action. (see diagram p. 23)
          » Attention - visual and auditory abilities that relate to the intake and processing of information from the environment.
          » Arousal - control and modulation of behavioral states from sleep to waking to crying, and the ability to display the entire range of states, from excitation to inhibition to incoming stimuli.
          » Affect - the development of sociability and emotion, the mutual regulatory processes of social interaction and social relationships.
          » Action - perceptual-motor function, the development of fine and gross motor skills, and the acquisition of knowledge and social exchange through motor patterns.

Indirect Effects:

1. Direct effects include the action of cocaine on the fetus consequent to transfer of the drug through the placenta.
2. Affects the sympathetic nervous system and produces vasoconstriction, an acute rise in arterial blood pressure, tachycardia, and a predisposition ventricular arrhythmia and seizures.

Direct Effects:

1. Indirect effects can be attributable to changes in the fetal environment and effects on the mother's CNS that place the infant at risk.
2. Impaired oxygen to the fetus, restriction of blood supply to the placenta.
3. Increased blood pressure can result in preterm labor, hemorrhage, shock, anemia, and a reduction in fetal weight.

Newborn Outcome:
     °Decrease in birth weight and head circumference
     °Symmetric pattern of growth retardation-depressed fat stores        and lean body mass
     °Increase fetal metabolism and thus cause depletion of fetal        nutrient stores, leading to fetal malnutrition
     °Postneonatal exposure to cocaine has been reported via        breast feeding, by direct ingestion, and by passive inhalation

for more information on "crack babies" click here

back to main "Prenatal Effects & Postnatal Outcomes of Cocaine Exposure" page