Cocaine embryofetopathy is a group of clinical signs observed in newborns exposed in utero to cocaine, a short-acting central nervous system stimulant used as a recreational drug through inhalation of the powder or intravenous injection. Very little data exist on the extent of cocaine use by pregnant women, but a study in the United States found that nearly 3% of pregnant women use illicit drugs such as marijuana and cocaine. Cocaine use during pregnancy increases the risk of premature birth, growth retardation (involving weight, length, and head circumference), and behavioural abnormalities in the offspring. Increased risk of miscarriage and fetal death was also reported. There is no agreement on whether cocaine use increases the risk of structural malformations, although several studies show a 4-fold increase in urinary tract anomalies in the offspring of cocaine-using women, and other studies show an increase in vascular disruption-type abnormalities (cranial defects including exencephaly, interparietal encephalocele, parietal bone defects; limb reduction defects; intestinal atresia, and abdominal wall defect). A possible association between prenatal exposure to cocaine and heart abnormalities has been suggested: the cardiovascular toxicity of cocaine may be increased by pregnancy. Major malformations must be searched for at level II ultrasound after prenatal exposure to cocaine.
Last update: May 2006
- Dr Elisabeth ROBERT-GNANSIA