A fetus cannot "just say no to drugs." Use of substances of abuse during pregnancy has skyrocketed in recent years, due in part to the ready availability of crack cocaine. The media have decried the burdens on our health care and educational systems imposed by the adverse consequences of prenatal exposure to cocaine. But how much do we really know about the effects of this insult? Is prenatal cocaine exposure a convenient excuse for the adverse outcomes associated with a myriad of physical and social ills afflicting the drug-using population? This volume presents the most recent scientifically-based knowledge about prenatal exposure to substances of abuse. Written by prominent researchers in the field, it describes what we do and do not know about:
* the mechanisms of the action of cocaine on the developing brain,
* strategies for studying this complex issue,
* the implications of drug exposure and a drug-using environment for long-term functioning in the cognitive, social and emotional domains, and
* possible intervention strategies to prevent developmental problems in children at high risk.
This volume will be a valuable addition to the libraries of researchers, policymakers and practitioners concerned about cocaine-exposed infants.
Table of Contents
Contents: C.L. Jones, Foreword. Preface. Part I:Models. D.L. Dow-Edwards, Developmental Toxicity of Cocaine: Mechanisms of Action. B.M. Lester, K. Freier, L. LaGasse, Prenatal Cocaine Exposure and Child Outcome: What Do We Really Know? B. Weiss, Incipient Hazards of Cocaine: Lessons from Environmental Toxicology. D.E. Hutchings, A.C. Zmitrovich, Methadone During Pregnancy: A Brief Review of Clinical Outcome and a New Animal Model. Part II:Methods. C.V. Vorhees, A Review of Developmental Exposure Models for CNS Stimulants: Cocaine. D.R. Neuspiel, The Problem of Confounding in Research on Prenatal Cocaine Effects on Behavior and Development. J.L. Jacobson, S.W. Jacobson, Strategies for Detecting the Effects of Prenatal Drug Exposure: Lessons from Research on Alcohol. H.C. Olson, T.M. Grant, J.C. Martin, A.P. Streissguth, A Cohort Study of Prenatal Cocaine Exposure: Addressing Methodological Concerns. M. Bendersky, S.M. Alessandri, M.W. Sullivan, M. Lewis, Measuring the Effects of Prenatal Cocaine Exposure. E.M. Ostrea, Jr., Meconium Drug Analysis. Part III:Outcomes. L.P. Spear, Alterations in Cognitive Function Following Prenatal Cocaine Exposure: Studies in an Animal Model. R. Needlman, D.A. Frank, M. Augustyn, B.S. Zuckerman, Neurophysiological Effects of Prenatal Cocaine Exposure: Comparison of Human and Animal Investigations. L.C. Mayes, M.H. Bornstein, Developmental Dilemmas for Cocaine-Abusing Parents and Their Children. S.M. Alessandri, M.W. Sullivan, M. Bendersky, M. Lewis, Temperament in Cocaine-Exposed Infants. L. Beckwith, S. Crawford, J.A. Moore, J. Howard, Attentional and Social Functioning of Preschool-Age Children Exposed to PCP and Cocaine in Utero. N.S. Woods, M. Behnke, F.D. Eyler, M. Conlon, K. Wobie, Cocaine Use Among Pregnant Women: Socioeconomic, Obstetrical, and Psychological Issues. Part IV:Intervention. A. Baxter, L.S. Butler, R.P. Brinker, W.A. Frazier, D.M. Wedgeworth, Effective Early Intervention for Children Prenatally Exposed to Cocaine in an Inner-City Context. T. Field, Cocaine Exposure and Intervention in Early Development.
"Overall, this is a good summary and overview of the knowledge in this area and the difficulties inherent in its gathering. Excellent in all respects. All levels."
Chapters by prominent researchers deal with what we do and do not know about the mechanisms of action of cocaine on thesdeveloping brain; strategies for studying this complex issue; implications of drug exposure and drug-using environment for long-term cognitive, social and emotional functioning; and intervention strategies to prevent problems in developing children who are at risk.
—The Brown University Child and Adolescent Behavior Letter.
"Each of the four sections of this work synthesizes a large body of empirical findings, and showcases the expertise and research experiences of the authors. However, this volume is especially useful given that these sections have been well-integrated; this allows the reader to progress from an understanding of the biological mechanisms underlying problems posed by intrauterine cocaine exposure to a discussion of several intervention approaches which have been employed in response to the problems of cocaine-exposed infants. Students, instructors, researchers, and clinicians who are concerned with the important problem of prenatal cocaine exposure will find this volume a welcome addition to their libraries."
"Hopefully, a book such as this one, with its up-to-date summary of the literature on risk, can inspire innovation on the part of child advocates to devise acceptable ways of minimizing the risks and maximizing the potentiation of the family for wholesome development of all its members, not just the children. This is a logical and much needed next step."
"...represents an exciting addition to the literature of human behavioral teratology. It is a comprehensive look at cocaine exposure -- from the vantage points of experimental and developmental psychology; neurophysiology; obstetrical pharmacology/developmental toxicology; clinical research methodology; and drug treatment/child intervention programs. The book deserves a wide readership!"
Center for Research for Mothers and Children, National Institute of Child Health
"...provides an excellent overview of the subject of prenatal cocaine toxicity. The problem continues to be important, even if the prevalence of abuse during pregnancy is less than was initially believed to be the case. The harmful effects of cocaine on the developing fetus reinforce the need for society to be especially vigilant about exposure of pregnant women to other potentially toxic agents in the environment because of the vulnerability of their infants."
—Richard E. Behrman, M.D.
Center for the Future of Children, The David and Lucile Packard Foundation, Los