COCAINE & THE UNBORN BABY Introduction This r

This research discusses cocaine use during pregnancy. High rates of drug abuse by women during childbearing ages are reported; children born to these women are vulnerable to the effects of this abuse. An understanding of the effects of drug abuse on both the mother and the child, during and after pregnancy, is necessary. Preventative interventions need to be developed for this problem, and nurse home interventions are considered.

Reports indicate that tremendous numbers of mothers and infants are affected by substance abuse; dysfunctional families with medical and socioeconomic problems are found, which appear to present many obstacles for the intervening nurse. More studies show the adverse effects of maternal cocaine use than show no adverse effects. Data from the 1990 Household Survey on Drug Abuse, by the National Institute on Drug Abuse (NIDA), showed 60 million women of childbearing age (15 years to 44 years) in the United States. Of these women, 50.8 percent used alcohol, 29 percent smoked cigarettes, 8 percent used illicit drugs, 6.5 percent used marijuana, and 3.5 percent used cocaine. The Inspector General of the Office of Health and Human Services estimates that 100,000 infants each year are exposed to cocaine in utero. Drug abuse is found not only in women of lower socioeconomic class; more women from middle and upper socioeconomic groups are found entering drug and alcohol rehabilitati

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inuria, hemolytic anaemia, renal impairment, thrombocytopenia, and pulmonary oedema (Campbell, Parr, & Shutt, 1996; Zaichkin & Houston, 1993). Consequences of prenatal drug abuse are considered devastating. The most common effects of cocaine exposure in newborns includes the following: decreased birth weight, head circumference, length, and Apgar scores; perinatal infections including sexually transmitted diseases; impairment in interactive and organizational abilities; neurophysiologic abnormalities; poor feeding; prematurity; and congenital urogenital anomalies (Zaichkin & Houston, 1993, p. 43). Infants are at high risk to develop sudden infant death syndrome. Infants are assessed for gestational age, respiratory distress, and congenital anomalies; priorities for the infant include thermoregulation, respiratory stabilization and oxygenation, cardiovascular status and perfusion, and glucose screening (neonatal seizures may be present due to abrupt drug withdrawal). The drug-exposed infant is at a high risk for hepatitis B virus (HBV) (Messmer, Meehan, Gilliam, White, & Donaldson, 1993; Zaichkin & Houston, 1993, p. 43). After birth, continuing care of the infant is needed. Infant behaviors may include crying or screa

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