ABSTRACT
The mechanism by which cocaine affects the fetus is not fully known, but is postulated to result from either a direct effect to the fetus or an indirect effect mediated through the maternal autonomic and cardiovascular system, especially at the level of the uterus. Crack/cocaine produces high cerebral concentrations rapidly, hence it elicits a strikingly powerful addiction that tends to render crack-addicted women unable to abstain or curtail its use during pregnancy despite the hazards posed to their fetuses and at the risk of losing custody of their offspring. The human correlates of such addiction-related behaviors during pregnancy have obvious detrimental consequences to the fetus. Since chronic exposure to cocaine during fetal life results in exposure to both the parent compound and its metabolites, neither hair nor meconium analysis can be used to discern which of these substances is responsible for the deleterious effects to the fetus.
