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BALTIMORE — One sister is 14; the other is 9. They are a vibrant pair: the older girl is high-spirited but responsible, a solid student and a devoted helper at home; her sister loves to read and watch cooking shows, and she recently scored well above average on citywide standardized tests.
There would be nothing remarkable about these two happy, normal girls if it were not for their mother’s history. Yvette H., now 38, admits that she used cocaine (along with heroin and alcohol) while she was pregnant with each girl. “A drug addict,” she now says ruefully, “isn’t really concerned about the baby she’s carrying...”
...But now researchers are systematically following children who were exposed to cocaine before birth, and their findings suggest that the encouraging stories of Ms. H.’s daughters are anything but unusual. So far, these scientists say, the long-term effects of such exposure on children’s brain development and behavior appear relatively small.
“Are there differences? Yes,” said Barry M. Lester, a professor of psychiatry at Brown University who directs the Maternal Lifestyle Study, a large federally financed study of children exposed to cocaine in the womb. “Are they reliable and persistent? Yes. Are they big? No.”
Cocaine is undoubtedly bad for the fetus. But experts say its effects are less severe than those of alcohol and are comparable to those of tobacco — two legal substances that are used much more often by pregnant women, despite health warnings...
...But experts say these findings are quite subtle and hard to generalize. “Just because it is statistically significant doesn’t mean that it is a huge public health impact,” said Dr. Harolyn M. Belcher, a neurodevelopmental pediatrician who is director of research at the Kennedy Krieger Institute’s Family Center in Baltimore...
...Dr. Frank, the pediatrician in Boston, says cocaine-exposed children are often teased or stigmatized if others are aware of their exposure. If they develop physical symptoms or behavioral problems, doctors or teachers are sometimes too quick to blame the drug exposure and miss the real cause, like illness or abuse.
“Society’s expectations of the children,” she said, “and reaction to the mothers are completely guided not by the toxicity, but by the social meaning” of the drug...
Moreover, most of the children in the studies are poor, and many have other risk factors known to affect cognitive development and behavior — inadequate health care, substandard schools, unstable family situations and exposure to high levels of lead. Dr. Lester said his group’s study was large enough to take such factors into account.
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