Cocaine is a local anesthetic as well as a CNS stimulant. It can either be inhaled or in the case of crack, smoked. Use of cocaine during pregnancy is associated with premature birth, IUGR, placental abruption, and low birth weight. (1) Other organ systems that can be affected by cocaine use in pregnancy include the brain, eyes, heart, GI tract, and lungs to name a few. (1) Virtually every organ system can be affected.
| Organ system | Abnormalities |
|---|---|
| Cardiac | VSD, ASD, cardiomegaly, heart block, hypoplastic left and right heart (2) |
| Respiratory | Accelerated Lung Maturity (1) |
| Gastrointestinal | NEC and intestinal perforation (1) |
| Visual | Eyelid edema, hypoplasia of the optic nerve, delayed visual maturation, altered refractive status of the eye (1) |
Pregnancy Complications: premature labor and delivery, spontaneous abortions, premature rupture of membranes, placenta previa, abruptio placentae, ruptured ectopic pregnancy. (3)
Fetal Complications: IUGR, fetal distress, cerebrovascular accidents, congenital anomalies. (3)
Infant Complications: Neurobehavior, mortality, hospitalizations. (3)
References:
1. Plessinger MA, Woods JR, Jr. Cocaine in pregnancy. Recent data on maternal and fetal risks. Obstet Gynecol Clin North Am. Mar 1998;25(1):99-118.
2. Meyer KD, Zhang L. Short- and long-term adverse effects of cocaine abuse during pregnancy on the heart development. Ther Adv Cardiovasc Dis. Feb 2009;3(1):7-16.
3. Briggs G, Freeman R, Yaffe S. A Reference Guide to Fetal and Neonatal Risk: Drugs in Pregnancy and Lactation. Vol 1. Seventh Edition ed. Philadelphia, PA: Lippincott Williams & Williams; 2005.
