ABSTRACT
In-utero exposure to cocaine and its derivatives pose major perinatal health problems for a
large number of infants and their mothers. Since the late 1980s when cocaine and crack use
last peaked in the United States, many investigators have focused on the physical, neuro-
developmental, and neuropsychological effects of prenatal cocaine exposure on infants
and young children. Although inconclusive on many crucial issues, published studies
reveal the beginnings of a profile of possible cocaine-related effects on neuropsychological
functions subserving arousal and attention regulation. That profile is informed by
preclinical studies in which important factors such as duration and type of exposure as well
as environmental conditions may be more adequately controlled. In this chapter, we
review the state of knowledge regarding the neurobiological effects of prenatal cocaine
exposure on the developing nervous system as elaborated through use of preclinical and
clinical models. Studies in this area represent an important interface between basic studies
of normal neural ontogeny and those of neuroteratology. Because cocaine is a potent
central nervous system stimulant, understanding its effects on developing brain not only
explicates the possible neurodevelopmental impairments resulting from intrauterine
exposure to a potential neurotoxin but also sheds light on mechanisms of normal neural
ontogeny. Cocaine is also a remarkably addictive drug and hence, the adults caring for
children prenatally exposed are often themselves hindered in their parenting by their
addiction and all the associated environmental perturbations that accompany a drug-using
lifestyle. Hence, we also present a model by which the biological vulnerabilities
potentially conveyed by prenatal exposure to cocaine interact with the environmental
handicaps accompanying life in a substance dependent world. First we turn to the central
tenets of a teratological perspective.
