ABSTRACT
The usage patterns and possible clinical effects of prenatal cocaine exposure are varied. There is a wide spectrum of maternal cocaine exposure, ranging from very occasional use to frequent binges up to the time of delivery. This chapter discusses clinical effects of prenatal cocaine exposure during the newborn period. It conceptualizes the mechanisms, a model of neonatal cocaine or metabolite intoxication, withdrawal, and fetopathic effects. It is important to separate intoxication, withdrawal, and fetopathic effects because each may have different predictive values for the long-term effects and for management. The magnitude of the epidemic of prenatal cocaine exposure precludes intensive follow up of all exposed neonates. Cocaine intoxication and/or intoxication from its major metabolite, benzoylecgonine, are manifest at birth or appear shortly after birth in neonates who have cocaine and/or benzoylecgonine in their plasma.
