Obstetric and neonatal effects of drugs of abuse.

With an increase in illicit drug use in North America, more fetuses are exposed to cocaine, cannabinoids, alcohol, cigarettes, and opioids. Whereas the adverse fetal effects of some agents have been established (for example, ethanol), those of other compounds are still controversial (for example, cocaine, THC). Two important trends may hamper our understanding of the potential reproductive risks of recreational drugs: 1. The clustering of many other risk factors in the same women. 2. A tendency to publish studies showing adverse reproductive fetal effects while discouraging reports of no effects by drugs and chemicals. Although short-term research has addressed some of the immediate postnatal physical and behavioral performance of these babies, much more work is needed to address the difficult questions of long-term neurobehavioral outcome in babies exposed to recreational drug abuse in utero.