Developmental risk for infants of maternal cocaine abusers: Evaluation and critique

Eighty-five studies of the effects of intrauterine cocaine exposure on the infant were critically reviewed. Forty-eight (56%) of the studies were prospective in design and 37 (44%) were retrospective. Although many of these studies interpreted their findings as supportive of the common perception that negative effects of cocaine on the infant have been clearly demonstrated, an examination of methodology used in many of the investigations calls this conclusion into serious question. Methodological issues identified in the studies included weaknesses in experimental design, drug detection, subject selection, analyses, and interpretation of results. Although exposure of the fetus to toxic chemicals in utero has been shown to have deleterious developmental effects, the nature and magnitude of these effects, especially with regard to cocaine remains unclear.