What are the risks with use of cocaine during pregnancy?
Cocaine use during pregnancy can affect a pregnant woman and her baby in many ways. During the early months of pregnancy, cocaine may increase the risk of miscarriage. Later in pregnancy, it may trigger preterm labor (labor that occurs before 37 completed weeks of pregnancy) or cause the baby to grow poorly. As a result, cocaine-exposed babies are more likely than unexposed babies to be born prematurely and with low birthweight. Premature and low-birthweight babies are at increased risk of health problems during the newborn period, lasting disabilities such as mental retardation and cerebral palsy, and even death. Cocaine-exposed babies also tend to have smaller heads, which generally reflect smaller brains and an increased risk of learning problems (8).
Some studies suggest that cocaine-exposed babies are at increased risk of birth defects involving the urinary tract and, possibly, other birth defects (9, 10). Cocaine may cause an unborn baby to have a stroke, which can result in irreversible brain damage and sometimes death.
Cocaine use during pregnancy can cause placental problems, including placental abruption. In this condition, the placenta pulls away from the wall of the uterus before labor begins. This can lead to heavy bleeding that can be life threatening for both mother and baby. The baby may be deprived of oxygen and adequate blood flow when an abruption occurs. Prompt cesarean delivery, however, can prevent most deaths but may not prevent serious complications for the baby caused by lack of oxygen.
After birth, some babies who were regularly exposed to cocaine before birth may have mild behavioral disturbances. As newborns, some are jittery and irritable, and they may startle and cry at the gentlest touch or sound (11). These babies may be difficult to comfort and may be withdrawn or unresponsive. Other cocaine-exposed babies “turn off” surrounding stimuli by going into a deep sleep for most of the day. Generally, these behavioral disturbances are temporary and resolve over the first few months of life (11).
Cocaine-exposed babies may be more likely than unexposed babies to die of SIDS. However, studies suggest that poor health practices that often accompany maternal cocaine use (such as use of other drugs and smoking) may play a major role in these deaths (12).