Children exposed in-utero to cocaine often have lower IQs and do poorly in school and with language, but a new research review concludes that these impairments can usually be traced to the troubled environment the children of cocaine users live in and not directly to the effects of the drug itself.

Researcher Maureen M. Black, Ph.D., and colleagues from the University of Maryland School of Medicine reviewed 32 previous studies on school-aged children who had been exposed to cocaine during pregnancy. They found that these children often had problems with sustaining attention and self-regulating their behavior. Some studies also showed that the exposed children exhibited differences in the white and gray matter in their brains.

“Cocaine can disrupt fetal growth and development, but this review tells us that just because a child has been exposed to cocaine, it is not a foregone conclusion that they’re going to be in trouble,” said Black. “No one is saying cocaine use is good. We need prevention programs so women don’t use cocaine in the first place. Children experience serious negative effects from drug exposure in the womb. It looks, though, as if cocaine doesn’t work alone. Women who use cocaine are often from poor and dysfunctional families, where children do not receive the care and enrichment they need. In addition, women who use cocaine while pregnant often smoke cigarettes and drink alcohol as well, exposing their unborn children to legal substances with extremely negative consequences.”

The study was published in the March 1, 2010 issue of the journal Pediatrics.