Cocaine abuse is a major public health problem. We followed prospectively a group of children exposed in utero to crack/cocaine (DG) and a SES matched control group (CG) since birth. Data was collected on maternal drug use, obstetrical, medical and psychosocial histories. Urine toxicologies were obtained prenatally and at birth. The infants were seen every 6 mos for somatic and neurobehavioral evaluations. Results at age 3 yrs are presented including somatic and neurological findings, Bayley Scales of Infant Development 2 and Behavior Rating Scale (BRS). The study group consisted of 116 children- 65 D(39% male and 61% female) and 51 C (65% male and 35% female) of Hispanic and African-American background. SES was similar for both groups. In the DG 27% and in the CG 6% were in foster care. Weight and height were similar. However, head circumference was significantly smaller in the DG(52± 30% vs 65± 28%). There were significantly more suspicious to abnormal neurological findings in DG consisting of abnormalities in tone, fine and gross motor coordination and developmental delays (p≥.001). The MDI and PDI were significantly lower in the D G (84.5± 13.6 vs 93.5± 13.8, p≥.001; 92.9±18.7 vs 101.4±18.5, p≥.02). The number of scores ≤ 85 were significantly higher in the DG(p≥.01). The BRS showed significant differences in the total score(p≥.02) and subscores in motor quality (p≥.02) and emotional/regulation(p≥.05) factors with C group scoring better. The language and motor coordination items were mostly affected. Significantly more D G children were referred for early intervention because of behavior and developmental problems. The Peabody Vocabulary Test (PVT) was administered to mothers of both groups and scores were similar. The MDI and PDI scores correlated with the PVT. The neurological exam correlated with the MDI, early intervention, BHR, and foster care. There was no relationshipsbetween prenatal drug use, obstetrical and neonatal complications and gestational age to outcome variables.

The children of D G showed significant differences in neurobehavioral development compared to control children. The most likelyfactors influencing outcome of DG are the interaction of pre- natal factors and the chaotic drug culture environment and inadequate, inconsistent nurturing.