|
Prenatal cocaine exposure (PCE) occurs when a pregnant woman uses cocaine and thereby exposes her fetus to the drug. "Crack baby" was a term coined to describe children who were exposed to crack (freebase cocaine in smokable form) as fetuses; the concept of the crack baby emerged in the US during the 1980s and 1990s in the midst of a crack epidemic.〔 Early studies reported that people who had been exposed to crack in utero would be severely emotionally, mentally, and physically disabled; this belief became common in the scientific and lay communities.〔 Fears were widespread that a generation of crack babies were going to put severe strain on society and social services as they grew up. Later studies failed to substantiate the findings of earlier ones that PCE has severe disabling consequences; these earlier studies had been methodologically flawed (e.g. with small sample sizes and confounding factors). Scientists have come to understand that the findings of the early studies were vastly overstated and that most people who were exposed to cocaine in utero do not have disabilities.〔 No specific disorders or conditions have been found to result for people whose mothers used cocaine while pregnant. Studies focusing on children of six years and younger have not shown any direct, long-term effects of PCE on language, growth, or development as measured by test scores. PCE also appears to have little effect on infant growth.〔 However, PCE is associated with premature birth, birth defects, attention deficit hyperactivity disorder, and other conditions. The effects of cocaine on a fetus are thought to be similar to those of tobacco and less severe than those of alcohol.〔 No scientific evidence has shown a difference in harm to a fetus between crack and powder cocaine.〔 PCE is very difficult to study because it very rarely occurs in isolation: usually it coexists with a variety of other factors, which may confound a study's results.〔 For example, pregnant mothers who use cocaine often use other drugs in addition, or they may be malnourished and lacking in medical care. Children in households where cocaine is abused are at risk of violence and neglect, and those in foster care may experience problems due to unstable family situations. Thus researchers have had difficulty in determining which effects result from PCE and which result from other factors in the children's histories. ==Historical context== During the crack epidemic of the 1980s and 1990s in the US, fear existed throughout the country that PCE would create a generation of youth with severe behavioral and cognitive problems.〔 Early studies in the mid-1980s reported that cocaine use in pregnancy caused children to have severe problems including cognitive, developmental, and emotional disruption.〔 These early studies had methodological problems including small sample size, confounding factors like poor nutrition, and use of other drugs by the mothers.〔 However, the results of the studies sparked widespread media discussion in the context of the new War on Drugs. For example, a 1985 study that showed harmful effects of cocaine use during pregnancy created a huge media buzz.〔〔 The term "crack baby" resulted from the publicity surrounding crack and PCE. It was common in media reports of the phenomenon to emphasize that babies who had been exposed to crack in utero would never develop normally. The children were reported to be inevitably destined to be physically and mentally disabled for their whole lives.〔 Babies exposed to crack in utero were written off as doomed to be severely disabled, and many were abandoned in hospitals.〔 Experts foresaw the development of a "biological underclass" of born criminals who would prey on the rest of the population.〔〔 Crime rates were predicted to rise when the generation of crack-exposed infants grew up (instead they dropped).〔 It was predicted that the children would be difficult to console, irritable, and hyperactive, putting a strain on the school system.〔 Charles Krauthammer, a columnist for ''The Washington Post'' wrote in 1989, "()heirs will be a life of certain suffering, of probable deviance, of permanent inferiority."〔〔 The president of Boston University at the time, John Silber, said "crack babies ... won't ever achieve the intellectual development to have consciousness of God."〔 These claims of soullessness, "biological inferiority" and "born criminals" living in "inner cities" played easily into existing class and racial prejudice. Reporting was often sensational, favoring the direst predictions and shutting out skeptics. At the time, the proposed mechanism by which cocaine harmed fetuses was as a stimulant—it was predicted that cocaine would disrupt normal development of parts of the brain that dealt with stimulation, resulting in problems like bipolar disorder and attention deficit disorder.〔 Reports from the mid-1980s to early 90s raised concerns about links between PCE and slowed growth, deformed limbs, defects of the kidneys and genitourinary and gastrointestinal tracts, neurological damage, small head size, atrophy or cysts in the cerebral cortex, bleeding into the brain's ventricles, obstruction of blood supply in the central nervous system.〔 Studies that find that exposure has significant effects may be more likely to be published than those that do not, a factor that may have biased reporting on the effects of PCE toward indicating more severe outcomes as the crack epidemic emerged.〔 Between 1980 and 1989, 57% of studies showing cocaine has effects on a fetus were accepted by the Society for Pediatric Research, compared with only 11% of studies showing no cocaine effects.〔 After the early studies which reported that PCE children would be severely disabled came studies that purported to show that cocaine exposure in utero has no important effects.〔 Almost every prenatal complication originally thought to be due directly to PCE was found to result from confounding factors such as poor maternal nutrition, use of other drugs, depression, and lack of prenatal care. More recently the scientific community has begun to reach an understanding that PCE does have some important effects but that they are not severe as was predicted in the early studies.〔 Most people who were exposed to cocaine in utero are normal.〔 The effects of PCE are subtle but they exist.〔〔〔 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Prenatal cocaine exposure」の詳細全文を読む スポンサード リンク
|