LONG-TERM EFFECTS OF PRENATAL DRUG EXPOSURE
Evaluation of long-term consequences of prenatal drug exposure is confounded by multiple factors; attribution of outcome to drug use alone is problematic. Inner city children are at risk for adverse developmental outcome regardless of in-utero exposures. Poor outcomes are strongly associated with poverty, unstable home conditions, violence in the home environment, and inadequate interaction with adult caregivers.
Language, behavior, attention, and emotional regulation are particularly vulnerable to prenatal drug exposure, perhaps in the context of other risk factors. A systematic analysis of 36 selected studies of the outcome of children with prenatal cocaine exposure found no consistent negative associations with physical growth, developmental or language test scores, or behavior, but possible associations with decreased attentiveness, emotional expression, and "soft" neurophysiologic findings were found. A meta-analysis of 101 studies of the effect on offspring of cocaine use during pregnancy revealed a slight reduction in IQ and significantly lower scores for receptive and expressive language among cocaine-exposed children.