ABSTRACT
In 1978, the neonatal mortality rate at New York City's Harlem Hospital for infants with birthweights greater than 500 grams was 19.2 per 1,000 live births. The tremendous increase in maternal cocaine abuse since 1985 has been accompanied by a steady 4 percent annual increase in the number of births in Central Harlem and New York City. The increase in maternal cocaine abuse has also been accompanied by a disturbing drop in the number of mothers who obtain adequate prenatal care. The effect of maternal cocaine abuse on infants has so far been easier to describe epidemiologically than physiologically. The report entitled, The Growing Crisis in New York City Neonatal Services, documented the resulting increased provider workload and compromise in prenatal services, which may explain in part why fewer mothers living in poor neighborhoods like Central Harlem seek prenatal care.
