1 effects , prognosis
1.1 pregnancy , birth
1.2 mental, emotional, , behavioral outcomes
1.3 physical outcomes
effects , prognosis
studies have returned varying reports of effects of pce: claim physical disabilities severe , generalized, others find specific effects, others none all. timing of dose of drug important determinant of outcome, in addition how used, how long, , kind of care rendered after birth. drug use in first trimester harmful fetus in terms of neurological , developmental outcome. effects of pce later in child s life poorly understood; there little information effects of in utero cocaine exposure on children on age five. studies have found pce-related differences in height , weight while others have not; these differences gone or small time children school age. still not known factors may exist aid children exposed cocaine in utero. unknown if effects of pce increased once children reach adolescence, or whether neural rewiring occurs during developmental period attenuates effects. review of 27 studies performed between 2006 , 2012 found cognitive development mildly moderately affected in pce adolescents, not clear how important these effects in practical terms.
unlike fetal alcohol syndrome, no set of characteristics has been discovered results uniquely cocaine exposure in utero. cocaine exposure in utero may affect structure , function of brain, predisposing children developmental problems later, or these effects may explained children of crack-using mothers being @ higher risk domestic violence, deadbeat parenting, , maternal depression. when researchers able identify effects of pce, these effects typically small.
pregnancy , birth
premature baby
studies have found after controlling other factors effects present in pregnancies involving cocaine: abruptio placenta, prematurity, low birth weight, , small size compared babies of same gestational time. pce newborns have smaller heads , shorter bodies. pce effects more severe when amounts of cocaine greater. many 17–27% of cocaine-using pregnant women deliver prematurely. in association prematurity, growth in womb reduced, , low birth weight connected pce. there data showing spontaneous abortion associated cocaine use. cocaine reduces appetite , has been linked reduced maternal weight gain during pregnancy; in addition, constriction of blood vessels may further limit supply of nutrients fetus. using cocaine while pregnant heightens chances of maternal , fetal vitamin deficiencies, respiratory distress syndrome baby, , infarction of bowels. reports found cocaine-exposed babies @ high risk sudden infant death syndrome; however, itself, cocaine exposure during fetal development has not subsequently been identified risk factor syndrome. some, not all, pce children experience hypertonia (excessive muscle tone), , reduced reflexes , motor function have been found in babies 4 6 weeks old.
while newborns exposed prenatally drugs such barbiturates or heroin have symptoms of drug withdrawal (neonatal abstinence syndrome), not happen babies exposed crack in utero; @ least, such symptoms difficult separate in context of other factors such prematurity or prenatal exposure other drugs.
mental, emotional, , behavioral outcomes
studies have shown small deficits in behavioral, cognitive, attention, emotional, , language function in pce infants, children, , adolescents. however, other studies attribute findings of negative effects on cognitive development confounding factors. studies suggest environment in child grows makes more important contribution outcome in cognitive, behavioral , other outcomes cocaine exposure itself. school performance mildly affected in older children. in iq studies, cocaine-exposed children not appear score lower others. although pce correlated low iq scores, scientists believe pce alone not cause effect; rather more due associated factors. in school-age , younger children, pce not appear in studies predispose children poorer intellectual performance. poor performance on iq tests due trouble sustaining attention if tests fail account factor separately.
cocaine causes impaired growth of fetus s brain, effect pronounced high levels of cocaine , prolonged duration of exposure throughout 3 trimesters of pregnancy. studies use neuroimaging such magnetic resonance imaging (mri) , fmri have shown differences in brain structure of pce children, example in cerebral cortex , limbic system. pce children had slowed brain growth fetuses @ higher risk impaired brain growth , motor, language , attention problems after born. studies have found children exposed cocaine during fetal development experience problems language, behavior, development, , attention. these effects small, when studies control other factors exposure other drugs. cognitive , attention skills can impacted pce, possibly due effects on brain areas such prefrontal cortex. brain areas in frontal lobe involved in dealing stress, attention, , impulsiveness seem particularly impacted pce, evidenced neuroimaging studies show abnormalities in these areas of brain. pce infants have been shown more jittery , excitable , have lower arousal , self-regulation; such behavioral effects may persist or worsen after 12 months of age. children mothers used cocaine during pregnancy may develop symptoms akin of attention deficit disorder, , link has been found between disorder , pce. mild deficits in language have been found in older pce children. language development impaired, possibly late adolescence, adolescents age 17 may improve receptive language skills.
evidence suggests in utero cocaine exposure leads problems behavior , sustained attention, possibly affecting parts of brain vulnerable toxins during fetal development. school-age pce children have been found have trouble regulating behavior , sustaining attention. children had been exposed high levels of cocaine in utero show poorer behavioral inhibition lower levels of exposure or unexposed children. changes in behavior , attention caused pce measurable standardized scales; these behavioral effects seem mild. children exposed cocaine in first trimester less sociable, more withdrawn, , show more anxious , depressed behaviors. exposed higher doses of cocaine have been reported show aggressive , disruptive behaviors. pce girls 7 times more have delinquent behavioral problems, pce boys no more other boys. studies 2000s , 2010s conflicted on whether pce adolescents @ greater risk use of drugs such cocaine, alcohol, , marijuana. 2010 study found pce adolescent girls more suffer anxiety non-exposed peers.
physical outcomes
slowed growth documented in fetuses, not clear whether older children remain smaller or catch peers. studies show growth remains slowed many ten years. pce may interfere way motor system matures. motor effects have been documented include poorer reflexes , quality of movement in infants. pce may have effect on neuroendocrine system, more study needed determine whether , effects are.
a review of literature reported cocaine use causes congenital defects between 15 , 20% of time; large-scale study found no difference in rates of birth anomalies in pce , non-pce infants. has been suggested birth defects due cocaine s disruption of blood vessel growth. pce-related congenital defects found in brain, heart, genitourinary tract, arms , legs. cocaine use pregnant mothers may directly or indirectly contribute defects in formation of circulatory system , associated abnormalities in development of aorta. heart malformations can include missing ventricle , defects septum of heart, , can result in potentially deadly congestive heart failure. genital malformations occur @ higher-than-normal rate pce.
the liver , lungs @ higher risk abnormalities. cloverleaf skull, congenital malformation in skull has 3 lobes, brain deformed, , hydrocephalus occurs, associated pce. birth defects, small head size, , stroke risks in pce.
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