From: pfcouvar@unix.amherst.edu (Peter F. Couvares)
Subject: Crack Baby Info (was Re: I seek references to "crack baby" refutations)
Organization: Amherst College
Date: Tue, 17 Nov 1992 02:18:30 GMT

Here's all I've culled off the net recently. I've lost the information
on who posted each--sorry if you're not mentioned.

-Peter

pfcouvar@unix.amherst.edu (Peter Couvares)

===

Article:  Edmonds, Patricia.  "A Quick Fix for the Drug War".  Seattle Times.
          June 3.  Page A16:

Focus:    Drug war in general.  Good information on Crack Babies.

Excerpt:    Still, those interviewed for this article generally agreed
          on one thing:  its a perilous mix when leaders try to make war
          on drugs, law on drugs and political hay on drugs at the same
          time.  On this point, a favorite cautionary tale concerns the
          375,000 crack babies.
            The story begins with Ira Chasnoff, a Chicago pediatritian,
          and his 1988 study of 154,856 births in 36 hospitals.  Through
          interviews and tests, he learned that in 11 percent of the
          births, the babies had been exposed to some quantity of some
          illegal drug at some time during pregnancy.
            Chasnoff did not say the babies were born addicted, or
          afflicted.  He did not say which mothers used cocaine daily
          and which used marijuana one weekend.  He said:  some quantity
          of some illegal drugs was used during pregnancy.
            Then Chasnoff did the arithmatic.  If there was drug exposure
          in even 10 percent of the 3.75 million births in the U.S.
          annually, that would be 375,000 babies.
            "That," Chasnoff said, "is as far as it went".

          [...goes on to detail how William Bennett used this study to
          show that there were 375,000 crack babies in the U.S./year...]

---

>
>               Author: Koren-G. Graham K.
>        Article Title: Cocaine in Pregnancy: Analysis of Fetal Risk
>	       Source: Vet-Hum-Toxicol.  1992 Jun.  34(3).  P 263-4
>	       Author: Owiny-J-R. Myers-T. Massmann-G-A. Sadowsky-D-W.
>		Title: Lack of Effect of Maternal Cocaine Administration on
>		       Myometrial Electromyogram and Maternal Plasma Oxytocin
>		       Concentrations in Pregnant Sheep at 124-145 Days'
>		       Gestational Age.
 
2
AU  - Koren G
AU  - Graham K
AU  - Shear H
AU  - Einarson T
TI  - Bias against the null hypothesis: the reproductive hazards of cocaine
      [see comments]
AB  - To examine whether studies showing no adverse effects of cocaine in
      pregnancy have a different likelihood of being accepted for
      presentation by a large scientific meeting, all abstracts submitted
      to the Society of Pediatric Research between 1980 and 1989 were
      analysed. There were 58 abstracts on fetal outcome after gestational
      exposure to cocaine. Of the 9 negative abstracts (showing no adverse
      effect) only 1 (11%) was accepted, whereas 28 of the 49 positive
      abstracts were accepted (57%). This difference was significant.
      Negative studies tended to verify cocaine use more often and to have
      more cocaine and control cases. Of the 8 rejected negative studies
      and the 21 rejected positive studies, significantly more negative
      studies verified cocaine use, and predominantly reported cocaine use
      rather than use of other drugs. This bias against the null hypothesis
      may lead to distorted estimation of the teratogenic risk of cocaine
      and thus cause women to terminate their pregnancy unjustifiably.
AD  - Department of Pediatrics
AD  - University of Toronto
AD  - Ontario
AD  - Canada.
SO  - Lancet 1989 Dec 16;2(8677):1440-2
DP  - 1989 Dec 16
TA  - Lancet
PG  - 1440-2
IP  - 8677
VI  - 2
qUI  - 9008115
 
3
AU  - Lutiger B
AU  - Graham K
AU  - Einarson TR
AU  - Koren G
TI  - Relationship between gestational cocaine use and pregnancy outcome: a
      meta-analysis.
AB  - Despite a growing number of studies that have investigated the
      reproductive effects of maternal cocaine use, a homogeneous pattern
      of fetal effects has not been established and there is little
      consensus on the adverse effects of the drug. We used meta-analysis
      to evaluate the reproductive risks of cocaine. We reviewed the 45
      scientific papers published in the English language dealing with
      effects of cocaine used during pregnancy on pregnancy outcome in
      humans, and identified 20 papers eligible for meta-analysis (cocaine
      use in pregnancy, pregnancy/fetal outcome studies, human studies,
      original work, cohort or case control studies, control group present,
      English language). Our analysis revealed that very few adverse
      reproductive effects could be shown to be significantly associated
      with cocaine use by polydrug users when compared to control groups of
      polydrug users not using cocaine [genitourinary malformations; odds
      ratio of 6.08 (95% CI 1.18-31.3); gestation age: Cohen's d 0.37 (CI
      0.2-0.55)]. When the control groups consisted of no drug users, the
      polydrug users abusing cocaine had a higher risk for spontaneous
      abortions [odds ration 10.50 (CI 11.74-64.1)]. Similarly, comparison
      of users of cocaine alone or no drug users revealed a higher risk for
      in utero death, in addition to genitourinary tract malformations.
      Analysis of continuous variables (head circumference, gestational
      age, birth weight and length) revealed that the effect size was
      dependent upon the nature of the comparison. Comparison of cocaine
      users to no drug users consistently yielded a medium effect size
      (Cohen's d) between 0.50 and 0.58, while comparison of
      polydrug/cocaine users to polydrug/no cocaine users provided effect
      sizes small to non existent (0.06-0.37). These discrepancies suggest
      that a variety of adverse reproductive effects commonly quoted to be
      associated with maternal use of cocaine may be caused by confounding
      factors clustering in cocaine users.
AD  - Department of Pediatrics
AD  - Hospital for Sick Children Toronto
AD  - Ontario
AD  - Canada.
SO  - Teratology 1991 Oct;44(4):405-14
DP  - 1991 Oct
TA  - Teratology
PG  - 405-14
IP  - 4
VI  - 44
UI  - 92074030

[note that Dr. Ira Chasnoff was responsible for a very great deal of the
original cocaine-baby research in the mid 1980s.]
 
4
AU  - Chasnoff IJ
AU  - Griffith DR
AU  - Freier C
AU  - Murray J
TI  - Cocaine/polydrug use in pregnancy: two-year follow-up [see comments]
AB  - The impact of cocaine on pregnancy and neonatal outcome has been well
      documented over the past few years, but little information regarding
      long-term outcome of the passively exposed infants has been
      available. In the present study, the 2-year growth and developmental
      outcome for three groups of infants is presented: group 1 infants
      exposed to cocaine and usually marijuana and/or alcohol (n = 106),
      group 2 infants exposed to marijuana and/or alcohol but no cocaine (n
      = 45), and group 3 infants exposed to no drugs during pregnancy. All
      three groups were similar in racial and demographic characteristics
      and received prenatal care through a comprehensive drug treatment and
      follow-up program for addicted pregnant women and their infants. The
      group 1 infants demonstrated significant decreases in birth weight,
      length, and head circumference, but by a year of age had caught up in
      mean length and weight compared with control infants. The group 2
      infants exhibited only decreased head circumference at birth. Head
      size in the two drug-exposed groups remained significantly smaller
      than in control infants through 2 years of age. On the Bayley Scales
      of Infant Development, mean developmental scores of the two groups of
      drug-exposed infants did not vary significantly from the control
      group, although an increased proportion of group 1 and 2 infants
      scored greater than two standard deviations below the standardized
      mean score on both the Mental Developmental Index and the Psychomotor
      Developmental Index compared with the control infants. Cocaine
      exposure was found to be the single best predictor of head
      circumference.(ABSTRACT TRUNCATED AT 250 WORDS)
AD  - Department of Pediatrics
AD  - Northwestern University Medical School
AD  - Chicago
AD  - IL.
SO  - Pediatrics 1992 Feb;89(2):284-9
DP  - 1992 Feb
TA  - Pediatrics
PG  - 284-9
IP  - 2
VI  - 89
UI  - 92131597
 
5
AU  - Graham K
AU  - Dimitrakoudis D
AU  - Pellegrini E
AU  - Koren G
TI  - Pregnancy outcome following first trimester exposure to cocaine in
      social users in Toronto, Canada.
AB  - Studies of drug-dependent women reveal high rates of adverse fetal
      effects of cocaine. However, no data are available on the effect of
      the chemical in social users who discontinue cocaine upon realizing
      they are pregnant. We report the results of the first phase of a
      prospective study examining the outcome of pregnancy in women seeking
      counseling from the Motherisk Program in Toronto. Of 25 women seen in
      our clinic for 1st trimester cocaine exposure, 92% reported use of
      less than 10 g of cocaine and 36% reported marijuana use. Other
      illicit drug use was rare; cigarette and alcohol use was common. The
      study group did not experience adverse pregnancy outcome above the
      rate expected in the general population. There were 23 single births
      1 pair of twins, and 1 spontaneous abortion. Birth weight and
      gestation were within normal limits. Only 1 child had a major
      malformation, syndactyly. Infant development was within normal
      limits, as measured by developmental milestones. All children are
      scheduled for assessment using the Bayley Scales of Infant
      Development. The results of the BSID will be compared to results from
      a cannabis-exposed control group and a no-drug control group.
AD  - Division of Clinical Pharmacology and Toxicology
AD  - Research Institute
AD  - Toronto
AD  - Ontario
AD  - Canada.
SO  - Vet Hum Toxicol 1989 Apr;31(2):143-8
DP  - 1989 Apr
TA  - Vet Hum Toxicol
PG  - 143-8
IP  - 2
VI  - 31
UI  - 89188370
{ 
2
AU  - Richardson GA
AU  - Day NL
TI  - Maternal and neonatal effects of moderate cocaine use during
      pregnancy.
AB  - Thirty-four women who reported using cocaine during pregnancy were
      compared to 600 women who reported no cocaine use during pregnancy
      and none for the year prior to pregnancy. Subjects were participants
      in a prospective, longitudinal study of prenatal substance use. The
      sample consisted of young, predominantly single, low-income women
      attending a public prenatal clinic. Women were interviewed at the end
      of their first, second and third trimesters regarding cocaine,
      alcohol, marijuana, tobacco and other drug use. The majority of the
      cocaine users were light to moderate users who decreased their use
      during pregnancy. The cocaine group was more likely to be white and
      to use alcohol, marijuana, tobacco and other illicit drugs more
      heavily than the comparison group. The cocaine users had more
      previous fetal losses but did not differ on other obstetrical
      complications. Infant growth, morphology and behavior were not
      affected.
AD  - Western Psychiatric Institute and Clinic
AD  - University of Pittsburgh
AD  - PA 15213.
SO  - Neurotoxicol Teratol 1991 Jul-Aug;13(4):455-60
DP  - 1991 Jul-Aug
TA  - Neurotoxicol Teratol
PG  - 455-60
IP  - 4
VI  - 13
UI  - 92017483

-------------------------------------- 

-marc anderson
andersom@spot.colorado.edu

>From CIVL097@csc.canterbury.ac.nz Tue Oct 13 17:07:03 1992
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 <01GPXQ9V7Z74E32ZS0@csc.canterbury.ac.nz>; Wed, 14 Oct 1992 11:06:34 +1300
Date: Wed, 14 Oct 1992 11:06:33 +1300
From: "Brandon Hutchison,Civil Eng Dept" <CIVL097@csc.canterbury.ac.nz>
Subject: Coke -babies, this may help?
To: hagerp@moose.cs.indiana.edu
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From:	CANTVA::CIVL097      "Brandon Hutchison,Civil Eng Dept" 10-AUG-1992 13:21:12.09
To:	IN%"karenw@tekig1.pen.tek.com",IN%"dcs@witsend.uucp",IN%"doug@doug.ksc.nasa.gov"
CC:	CIVL097
Subj:	Crack babies/crack mothers


Here is some material which I have extracted from the News.
It seems that Chasnoff, who has done much work on "coke babies" has 
recanted some of his conclusions.

The term "crack mothers", used in my posting was not mine, I was replying
to another poster who used it.

It is very hard to get objective information on any drug issue so I can't
make categorical statements, only relay my suspicions,hunches and
impressions.

Being fairly certain that we've all be fed a lot of lies,distortions, and
propaganda on cannabis,heroin and lsd, and seeing articles appearing in the
mainstream press questioning the "crack baby" crisis, it is now my 
impression that we are being fed lies,distortions and propaganda about
crack and cocaine.

>> In the stories I've seen, the same
>> people you cite (most notably, Chasnoff) are quoted as saying
>> that their early findings were just plain wrong.




    (From _The Boston Sunday Globe_ * January 12, 1992,     pg 69)
    (Permission to reproduce this article has not been sought)

    THE MYTH OF THE `CRACK BABIES'

    By Ellen Goodman


    They are called "a biological underclass" and "a lost generation." 
    Those are just two of the milder name tags attached to the children we
    have come to believe were permanently damaged by their mothers' use
    of cocaine.

    The poster in maternity clinics conjure up the same image of the
    prenatally doomed: "Some people who smoke crack never get over it." 
    The schools too have been put on emergency alert: "The crack babies are
    coming, the crack babies are coming."

    Indeed, the phrases "crack babies" and "crack kids" are shorthand for
    monster-children who are born addicted.  These are the kids destined to
    grow up without the ability to pay attention or to learn or to love.

    But just when the name has stuck, it turns out that "crack baby" may be
    a creature of the imagination as much as medicine, a syndrome seen in
    the media more often than medicine.

    Three years after the epidemic of stories about these children began,
    six years after hospitals began to see newborns in deep trouble,
    researchers are casting doubt on the popular demon of the war on drugs. 
    The very phrase "crack baby" is, in any literal sense, a misnomer. 
    Cocaine is rarely taken by itself.  It's part of a stew of substances
    taken in a variety of doses and circumstances.  No direct line has been
    drawn from the mother's use of cocaine to fetal damage.

    Alcohol and tobacco may do as much harm to the fetus as cocaine.  So
    may poor nutrition, sexually transmitted diseases, and the lack of
    medical care.  Most important, it appears that the children born to
    cocaine-using mothers are not hopeless cases, permanently assigned to
    the monster track.  Dr. Ira Chasnoff, who did some of the original work
    identifying the problem babies of mothers who took cocaine in
    combination with other drugs, has done a two-year follow-up study about
    to be published.  It says, in his words, "Their average developmental
    functioning level is normal.  They are no different from other children
    growing up.  They are not the retarded imbeciles people talk about.

    This is not, he cautions, a green light for taking drugs during
    pregnancy.  Drugs remain a serious health problem, and cocaine
    specifically contributes to premature birth and small head size.  While
    the children in his study - children who have been offered some help -
    now function normally as a group, they are at risk individually.

    But, says Dr. Chasnoff, "As I study the problem more and more, I think
    the placenta does a better job of protecting the child than we do as a
    society."  The need now is to widen the lens from nature to nurture, and
    from the environment of the unborn to that of the born.

    Another researcher who has taken a responsible second look at the
    "crack baby" syndrome is Claire Coles of Emory University.  She
    believes these children, labeled by their drug of origin, are in fact
    "often victims of gross neglect, not brain damage."

    The worst damage that drugs may do is to the world a child inhabits
    after birth.  Coles has a collection of horror stories about children
    growing up neglected, especially by cocaine addicts.  One "crack kid"
    who couldn't concentrate in class was in fact hungry.  Another poorly
    developed "crack baby" was being "raised" by a 5-year-old sister.

    The myth of the "crack baby" became a media hit, Coles believes,
    because "crack is exotic and happening mostly in `marginal' populations
    among `bad people' who are not like `us.'"  It is easier to think about
    crack than alcohol or tobacco.  There is more than a touch of racism in
    the attention.

    But perhaps the worst effect of this distortion is the sense of
    hopelessness dispensed with the title "crack kid."  Hopelessness on the
    part of mothers, teachers, and even the children themselves.  As Coles
    warns, "If a child comes to kindergarten with that label, they're dead. 
    They are very likely to fulfill the worst prophecies."

    So, no more convenient and empty names.  The children whose mothers
    used cocaine are neither universally nor permanently nor uniquely
    damaged.  The so-called "crack kids" are just a portion of our growing
    population of children in deep trouble.  They are only children, like
    so many others, growing up with a treacherous mix of nature's and
    nurture's woes.

    If you need a label, call them kids who need help.

            - Ellen Goodman is a Globe columnist.

------------------------------------------------------------------------------


 other references extracted from the Usenet News

               Author: Koren-G. Graham K.
          Institution: Department of Pediatrics & Research Institute,
		       Hospital for Sick Children, Toronto, Ontario, Canada
        Article Title: Cocaine in Pregnancy: Analysis of Fetal Risk
	       Source: Vet-Hum-Toxicol.  1992 Jun.  34(3).  P 263-4
	     Abstract: During the last decades there has been a substantial
		       increase in the recreational use of cocaine in young
		       adults and parallelly there has been an increase in
		       its use by pregnant women. We analyzed all published
		       papers on cocaine use in pregnancy and found that
		       for most endpoints studied (eg, prematurity, head
		       circumference) there were many studies showing
		       effects and many showing no effects.  Upon meta-
		       analysis, most of the effects could not be shown
		       significant when compared to control groups.  In
		       a prospective study in Toronto, babies exposed to
		       cocaine during the first trimester only had Bayley
		       scores at 18-mo of life that were identical to
		       unexposed babies or to those exposed to canabinoids.
		       Motherisk presently counsels women who discontinue
		       cocaine use in the first trimester of pregnancy that
		       there is no increased developmental risk for the baby.

	       Author: Neuspiel-D-R
	        Title: Cocaine-Associated Abnormalities May Not Be
		       Causally Related.
	       Source: Am-J-Dis-Child. 1992 Mar. 146(3). P 278-9

	       Author: Mayes-L-C. Granger-R-H. Bornstein-M-H. Zuckerman-B.
	  Institution: Yale Study Center, New Haven, Conn 06510
	        Title: The Problem of Prenatal Cocaine Exposure. A Rush
		       to Judgement
	   References: Review Article: 43 refs.
	       Source: JAMA.  1992 Jan 15.  267(3).  P 406-8

	       Author: Owiny-J-R. Myers-T. Massmann-G-A. Sadowsky-D-W.
		       Jenkins-S. Nathanielsz-P-W.
	  Institution: Laboratory for Pregnancy and Newborn Research, College
		       of Veterinary Medicine, Cornell University, Ithaca,
		       New York.
		Title: Lack of Effect of Maternal Cocaine Administration on
		       Myometrial Electromyogram and Maternal Plasma Oxytocin
		       Concentrations in Pregnant Sheep at 124-145 Days'
		       Gestational Age.
               Source: Obstet-Gynecol.  1992 Jan.  79(1).  P 81-4



I try to keep an open mind on this issue. If you have any specific references
point me at them.


Brandon Hutchison,University of Canterbury,Christchurch
                  New Zealand

>From manning@alumni.cco.caltech.edu Tue Oct 13 17:37:42 1992
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From: manning@alumni.cco.caltech.edu (Evan Marshall Manning)
Date: Tue, 13 Oct 92 15:38:34 PDT
Message-Id: <9210132238.AA01455@alumni.cco.caltech.edu>
To: hagerp@moose.cs.indiana.edu
Subject: Re: Request for cite ... "crack babies"
Newsgroups: alt.drugs,talk.politics.drugs
Status: RO

In talk.politics.drugs you write:


>I seem to have lost my cite for the metasurvey that invalidated 
>the assertion that thousands of crack babies were being born.
>Could some kind soul please post?  

This is from _Science_News_ some time in November 1991.  Sorry I
don't have the exact date.
-----------------------------------------------------------------

"Smoking out cocaine's _in_utero_ impact"

Despite many reports of cocaine's ill effects on the developing
fetus, scientists lack definitive evidence specifically linking
cocaine to adverse reproductive effects (SN: 9/7/91, p.152).
Using a powerful statistical technique, a Canadian research
team has found that cocaine by itself causes very few problems
during pregnancy.

Gideon Koren of the University of Toronto and his colleagues
identified 20 previously published cocaine studies that in-
volved pregnant women and yielded mixed results.  Those
studies often relied on small samples of cocaine users -- a
problem that limited each study's statistical power.

To home in on cocaine's reproductive risks, his team turned
to a method called meta-analysis, which statisticians use to
assess data by pooling a number of similar studies.  Koren and
his colleagues identified women in the 20 studies who used
cocaine during pregnancy but did not use other illicit drugs or
alcohol, and compared them with those who reported no drug
or alcohol use during pregnancy.  They found no statistical link
between prenatal cocaine use and premature delivery, low
birthweight or congenital heart defects in babies -- problems
often thought to result from cocaine.

The meta-analysis suggests that confounding factors -- such
as other drugs, alcohol and smoking -- may account for the fetal
growth retardation or prematurity commonly ascribed to
cocaine, the researchers assert in the October _TERATOLOGY_.

Koren says women who use cocaine tend to smoke more
cigarettes than women who use other illicit drugs and are more
likely to drink alcohol and take additional drugs.

The meta-analysis did reveal a chance that a pregnant
woman's cocaine use by itself might cause malformations of the
genito-urinary tract in a small number of infants.  Koren says
this effect may trace to cocaine-induced constriction of the
placental blood vessels.

---
Newsgroups: alt.drugs