Crack Babies
A report on NPR’s Morning Edition
Wednesday, 17 April 2002
Bob Edwards. A study suggests that babies who were exposed to cocaine in the womb face a much higher risk of developmental problems than other children. That’s a departure from many earlier studies that found little or no effect. NPR’s Rachel Jones reports that some researchers worry about how this new data will be used.
Rachel Jones. When Lynn Singer began her study of Cleveland infants and cocaine exposure back in 1994, she knew what she was up against. She keeps a constant reminder in her office.
Lynn Singer. I have one headline which says “Crack Babies Turn Five and Schools Brace,” as if, you know, these kinds of groups of children were just going to be running wild in the schools.
Jones. Singer is a professor of pediatrics and psychiatry at the Case Western Reserve University School of Medicine in Cleveland. She knew earlier research had fueled the stereotype of the crack baby: a tiny newborn racked with pain and doomed to a life of disability. She also knew later research following those infants into childhood did not support that stereotype. But those newer studies had problems. Singer says they used small samples, there were high dropout rates, and they used an outdated measure of child development. So Singer and her colleagues decided to improve on the research, first by using a large sample. They recruited 415 low-income, mostly African American mothers and their children. Singer says they were just following their instincts.
Singer. We know it [crack cocaine] has effects on the vascular system, the cardiac system, and so there are strong effects on adults and it makes sense to think that there are effects on the fetus.
Jones. 218 women used cocaine during pregnancy, and the rest did not. Singer says her study did a better job than most in controlling for mothers’ incomes, education levels, rates of depression, and interaction with the children. They also used an updated scale to measure the children’s development. That made a big impact on the results, Singer says.
Singer. We found a developmental difference in the children, even when we accounted for as much as we could for all of the other factors in the child’s life.
Jones. By age two, cocaine-exposed children were twice as likely to a significant cognizant delay than the other children in the study. Singer says her research is much better, but she urges caution in interpreting the results. She doesn’t want to refuel the crack baby stereotype.
Singer. It’s very clear that many children with the right kind of intervention are not going to be any different from other children.
Jones. Singer is not the only one concerned about how the study will be used. Deborah Frank is a professor of pediatrics at the Boston University School of Medicine. She fears this well-intentioned study could hurt mothers too.
Deborah Frank. The worst result of this publication would be that it would cause for another outcry to arrest and prosecute cocaine-using women, which would drive women away from health-care providers.
Jones. Frank co-wrote an editorial accompanying the study, which appears in this week’s Journal of the American Medical Association. She applauds the research, but also points to some of its flaws. Many of the cocaine-exposed infants were also premature, so it’s hard to tell which condition had a greater effect. And even though researchers tried to measure the impact of poverty, Frank says it creates a double jeopardy that is hard to disentangle. But she and Lynn Singer agree that there is a pressing need for more substance abuse treatment. Singer warns of yet another erroneous stereotype.
Singer. Many people believe that drug addiction programs are out there for the asking. But anyone can tell you that it’s [still] very hard for women who are pregnant to get good drug treatment.
Jones. Singer will continue to follow the developmental progress of children in her study. She says it’s the only way researchers can eventually reach a definite conclusion. Rachel Jones, NPR News, Washington.