Because I can’t ever share good news…Study on “crack babies” yields unexpected, but clear results

I saw this on Twitter on Monday, and decided to read the article. Susan FitzGerald wrote the piece, which was published over the weekend. The study looked at the long-term development of children exposed to cocaine in their mother’s womb and was located in Philadelphia. The expected results were yes, exposure to cocaine in-utero would yield negative results on the long-term development of these children, but instead the researchers found another factor more critical. The study followed the children for decades in every aspect of their development, progress as an infant, preschool IQ, adolescent brain development, etc. 

In 1989, one in six babies born in Philly to mothers who tested positive for cocaine. Hallam Hurt, the then chair of neonatology at Albert Einstein Medical Center on North Broad Street, began a study to evaluate the effects of in-utero cocaine exposure in babies during the rise of crack cocaine. Stories circulated about “crack babies” which included descriptions of small heads, agitation, tremors, poor muscle tone, aloofness, eye contact avoidance. Social workers predicted a generation of children with learning disabilities and enable to form meaningful relationships. The “crack baby” became emblematic of bad mothering resulting in some women having their children taken from them and even a few arrests. It also greatly impacted the notion of the "welfare queen."

This is the climate where Hurt created the study of 224 near-term or full-term babies born at Einstein between 1989 and 1992 half with mothers who used cocaine during pregnancy and half who were not exposed to cocaine in utero. All the babies were from low-income families and nearly all were African Americans. The study aimed to help medical caregivers caring for the babies and guide policy for drug policy and prevention. The study became one of the longest and largest studies on in-utero drug exposure funded by the National Institute on Drug Abuse. 

Hurt is quick to note that cocaine has devastating effects on pregnancy such as a rise in a woman’s blood pressure, can trigger premature labor, and maybe linked to a dangerous condition where the placenta tears away from the uterine wall. Additionally, premature babies are at risk for a variety of medical and developmental problems regardless of cause, and drug use creates a chaotic home for a child. 

In the study babies were evaluated periodically, from six months and then every six to twelve months through young adulthood. Additionally, the mothers were tested periodically though the study. The researchers consistently found no significant differences between the cocaine-exposed children and the control group. 

“At age 4, for instance, the average IQ of the cocaine-exposed children was 79.0 and the average IQ for the non-exposed children was 81.9. Both numbers are well below the average of 90 to 109 for U.S. children in the same age group. When it came to school readiness at age 6, and 25 percent of children in each group scored in the abnormal range on tests for math and letter and word recognition.”

At this point, Hurt began looking for other causes and factors at play. Both groups lag on developmental and intellectual measures compared to the norm. As the children aged, the researchers were able to tease out other factors at play. Some findings:

• Children from burturing homes, defined as caregiver warmth and affection and language stimulation, did better than kids in less nurturing homes.
• 81% of children had seen someone arrested; 74% had heard gunshots; 35% had seen someone get shot; and 19% had seen a dead body (the kids were about 7 at the time).
• Children exposed to violence were more likely to show signs of depression, anxiety, and lower self-esteem.
• The researchers found one area of the brain that could be affected by cocaine exposure, but the researchers found no significant differences between the groups’ behavioral functioning.

The years of tracking the children yielded the conclusion that poverty has a more influence on the outcome of inner-city children than exposure to cocaine in–utero. Take a minute and think on that. This could have a significant impact on the educational system and poverty programs, but at this point we don't really know how the study's findings will be applied in any concrete way.