Many predicted the 1980s crack epidemic would create a generation of children with major developmental and behavioral problems, but a new study found much of that hype hasn't panned out.
Researchers from the Department of Pediatrics at the University of Maryland School of Medicine found that the effects of crack cocaine in utero had only small effects on adolescent behavior, cognition and school performance. Crack is a more addictive, crystalized form of cocaine that is smoked for a intense high.
The problems traced to maternal crack cocaine use, such as a 1-point difference in IQ scores, weren't clinically meaningful, said Maureen Black, a professor and one of the lead authors of the study.
"The potential scare we saw in the '80s did not come to fruition," Black said. "The kids really do not look any worse off than their next-door neighbor."
Social factors such as poverty and exposure to violence had a bigger effect on a teenager's behavioral and mental development, the researchers found. When children live in poverty, they may not have exposure to books, may be afraid to play outside, watch too much television and have parents who have trouble putting food on the table, Black said.
The research, was published Monday in the online journal Pediatrics. While other studies have found similar results, the researchers said this was the first widespread study looking at babies exposed to crack as they grew into young adults.
The researchers examined 27 studies around the country that followed babies exposed to cocaine while in utero into adolescence.
Studies among adolescents are important because there are additional cognitive and social skills, such as abstract reasoning, that take shape during adolescence and would not have been evident earlier in childhood, the researchers said.
Black said the researchers have become better at studying the impact of cocaine over the years, adjusting for social factors and comparing kids exposed to crack cocaine as babies to children who live in similar environments but were not exposed to the drug. Scientists also have been better able to adjust for alcohol and tobacco use.
Concerns about the health impacts of cocaine exposure in utero came a decade after problems with fetal alcohol syndrome in the 1970s. Unlike crack cocaine, fetal alcohol syndrome did cause developmental problems in babies, including deformed facial features and developmental disorders. Black believes many doctors thought the same fate would befall babies exposed to crack.
The crack baby story made headlines in the 1980s and early indicators found that these babies did have some problems, such as jitters. But those health issues were later believed to have started because the babies were often born prematurely.
Black said that while the developmental problems of babies exposed to crack were minimal, the stigma may have had a long-lasting effect on their lives. Society may have written many of the children off as having no potential in life, she said.
"When you think about something like what the crack baby scare has done to children, it generally has not helped kids," Black said. "There has been a prejudice against children who may have been exposed to cocaine."
Scientists who review articles before publishing in publications such as Pediatrics, pushed the University of Maryland researchers hard to make sure there was no evidence of health problems associated with crack exposure, Black said.
"Reviewers are brutal," Black said. "We looked hard for affects, and the reviewers pushed us hard to find affects. But we just found that there weren't significant differences."
Washington-based National Advocates for Pregnant Women said medical inaccuracies also can have widespread policy consequences. The group's executive director, Lynn M. Paltrow, said the crack baby myth helped lead to heavier prison sentences for those who use crack rather than cocaine.
She said similar myths are being spread about the effect of opiates on babies whose mothers use the drugs.
"This conclusion cannot be repeated often enough," Paltrow said about the University of Maryland research. "The media and medical misinformation about prenatal exposure to cocaine was so destructive and so overwhelmingly believed — partly because it had to do with low-income African-American women — that it continues to undermine maternal, fetal and child health across the country."
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