Prenatal cocaine exposure: implications for practice, policy development, and needs for future research.

Terms such as coke babies and crack babies are appearing with increased frequency in the popular literature. Although the number of babies exposed to cocaine in utero has increased, synthesis of the literature to help determine the manifestations of cocaine exposure or to direct research on the problems experienced by cocaine-exposed infants and their care givers has yet to occur. In this analysis a synthesis of the literature related to the effects of perinatal cocaine exposure is provided. The manifestations, effects, and sequelae of cocaine exposure are explicated and a model is proposed to explain the mechanisms underlying physiologic and psychosocial expressions of exposure. Both time of exposure during gestation and dose relationships were identified as major predictor variables. Recommendations include the need for (1) an individualized intervention protocol and (2) prevention programs directed at pregnant women and women of childbearing age.