A study of so-called "crack babies" born in the 1980s and 90s showed that many of the desperate alarms sounded at the time about the devastating effects of pre-natal exposure to crack cocaine were gross overreactions. According to the Philadelphia Enquirer, the ill effects of poverty and childhood exposure to violence are even more harmful to children than in utero exposure to drugs.

"Poverty is a more powerful influence on the outcome of inner-city children than gestational exposure to cocaine," said Hallam Hurt, former chair of neonatology at Albert Einstein Medical Center. In the late 1980s, Hurt and her colleagues became alarmed at the number of new mothers they were seeing who were addicted to cheap, smokable "crack" cocaine.

As use of the drug spread and became more common, stories began to circulate of horrible birth defects associated with pre-natal crack use. Hurt organized a comprehensive study to follow some 224 babies born to mothers who had used crack while pregnant. She wanted to see if there was any truth to rumors she was hearing of "crack babies" with small head sizes at birth, muscle tremors, nerve damage and difficulty focusing on and tracking faces and other objects.

In the media, a racially and economically tinged fear campaign about crack babies spun up as pundits and anti-drug crusaders predicted a generation of children whose adult IQs would never be higher than 50. The damage done by pre-natal crack exposure "was interfering with the central core of what it is to be human," predicted one psychologist. Another portentously warned that the children of crack-using mothers would be "doomed to a life of uncertain suffering, of probable deviance, of permanent inferiority."

Hurt -- who is now professor of pediatrics at the University of Pennsylvania -- and her colleagues followed the children for 25 years, receiving $7.9 million in federal funding, as well as grants from Einstein Hospital. The study found, in fact, that what was affecting the group of inner city children far more than their parents' drug use was poverty. In IQ and developmental tests, the cocaine-exposed children scored right alongside their non-exposed classmates. The inner city children's average, however, was below the national level by up to 10 points in IQ testing.

"We went looking for the effects of cocaine," Hurt said to the Enquirer. But after a time, she said, "we began to ask, 'Was there something else going on?'"

By the time the children in Hurt's study were seven years old, "81 percent of the children had seen someone arrested; 74 percent had heard gunshots; 35 percent had seen someone get shot; and 19 percent had seen a dead body outside." Children with higher exposures to violence suffered from anxiety, depression and low self-esteem in addition to developmental delays.

Hurt is careful to say that cocaine can have devastating effects on health, especially on pregnant women. The drug can trigger serious spikes in blood pressure and has been linked to a dangerous syndrome in which the placenta tears away from the uterine wall. Cocaine can also cause premature labor and there is no dispute that premature birth can result in a host of health issues for babies.

Other studies of babies born to crack-addicted mothers failed to find the devastatingly low IQs and cognitive disabilities that they expected. An Emory University study by psychiatry professor Claire Coles found that pre-natal cocaine exposure did not affect children's ability to think and learn, but some of them were less able to govern their responses to stressful stimuli, which could affect their learning or overall emotional health.

Boston University professor of pediatrics Deborah A. Frank said that the media hype about crack babies has been damaging and counter-productive. "You can't walk into a classroom and tell this kid was exposed and this kid was not," told the Enquirer. "Unfortunately, there are so many factors that affect poor kids. They have to deal with so much stress and deprivation. We have also found that exposure to violence is a huge factor."

[image of discarded crack pipe by Marc Falardeau via Flickr Creative Commons]