Crack Babies: False Image

"Crack babies" may be false image, US report says
By David Bailey

CHICAGO, March 27, 2001 (Reuters) - Images of undersized, emotionally disconnected "crack babies" born to women who smoked cocaine rocks are wrong, with the infants' problems more likely caused by their mothers' smoking cigarettes, drinking or simply by poverty, researchers said on Tuesday.

The widely held belief that a pregnant woman's cocaine use causes her newborn's developmental and behavioral deficiencies is not backed up by " careful science," according to an analysis of 36 studies performed since 1984.

"As rates of cocaine addiction soared in the late 1980s and early 1990s, the media described these children as 'doomed,' a biological underclass of children unable to learn or love," said study author Deborah Frank of Boston University.

"That is simply not the case. In fact, the research suggests that poverty plays a much more destructive role in these children's lives than prenatal cocaine exposure," she said.

"Much of the findings that were initially attributed to cocaine, in fact, seemed to be related to cigarettes and alcohol or to other risks, such as poverty, which is the most serious risk of all," Frank said.

The report's conclusions, published in this week's Journal of the American Medical Association, come on the heels of a related Supreme Court ruling that declared public hospitals cannot test pregnant women for illicit drugs without their consent and then provide the results to police for possible prosecution.

The stigma of giving birth to a "crack baby" has led to the prosecution of more than 200 U.S. women since 1985 on charges that their use of the drug while pregnant constituted a crime against the fetus, the report said.

The issue has become embroiled in the national abortion debate, pitting the rights of a woman against those of her unborn baby, according to a commentary accompanying the report.

The research found no consistent association between prenatal cocaine exposure and the children's physical growth or development. Motor skill deficiencies linked to cocaine exposure usually disappeared after age 7 months, it said, adding that more research was needed on the drug's neurological effects.

"Although it would be inaccurate to say that we're absolutely sure that there are no adverse physical or mental effects of prenatal cocaine exposure, I think we can say that the popular stereotype of the distraught child who is unable to love and unable to learn is absolutely inaccurate," Frank said.

"The other thing that became quite clear was the quality of the children's environment has a much stronger effect on the children's outcome than the prenatal exposure," Frank said.

The twitching observed in some so-called "crack babies" may actually be a withdrawal symptom related to prenatal exposure to heroin or methadone, a manageable condition, she said.

In the accompanying commentary, Wendy Chavkin of the Columbia School of Public Health in New York called the stereotypical "crack baby" a convenient symbol for those who condemn drug users and for those who oppose abortion.

"As citizens, we may fall on different sides of these debates on abortion and drug addiction. Yet, as physicians and public health advocates, we can follow the example of (the researchers) and raise a calm steady voice for science and therapy," Chavkin wrote.

Copyright 2001 Reuters Limited.

Abstract: JAMA. 2001;285:1613-1625
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