Maternal use of illicit drugs may place their infants at risk for neurodevelopmental delay. We prospectively evaluated sixty consecutive infants discharged from the level II nursery at a large community hospital, comparing those infants exposed to nacrotics or cocaine during pregnancy (drug exposed, n=12), with other high risk but non-drug exposed infants (n=48). Assessment at mean corrected age 2 mos included anthropometric measurements, neurological exam and developmental testing including the Alberta Infant Motor Scale (AIMS) and the Bayley Scales of Infant Development. Of the drug exposed infants, 5 mothers were on methadone maintenance and 7 had cocaine or IV narcotic use. Five (42%) drug exposed infants were premature, compared with 33 (69%) non-drug exposed (p=ns). The other 15 non-drug exposed infants had infections(Group B Strep, HSV), or a history of asphyxia. There were no differences in APGAR score, birth weight (2400±705gm vs 2256±972gm), gestational and maternal age and duration of oxygen use between the groups. Neurodevelopmental results are shown: Table Analysis of covariance covarying for SES demonstrated a reduction in AIMS and head circumference in drug exposed compared to non-exposed infants (p=0.05 and p<0.05 respectively). We conclude that infants with in utero exposure to cocaine or narcotics demonstrate a smaller head circumference and slower motor development at 2 months than non-drug exposed infants. Developmental evaluation, early intervention and social services are indicated for these children.

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