Perinatal cocaine use: maternal, fetal, and neonatal effects.

The implications of cocaine use during pregnancy include an increased incidence of stillbirths, abruptio placentae, and an increased risk of other delivery complications. The neonate born to a woman using cocaine may show a lack of definite physical stigmata, absence of consistent withdrawal patterns, and high incidence of irritability during the neonatal period. Nursing implications for promoting optimal pregnancy and neonatal outcome primarily involve early pregnancy intervention, consistent care, education, and delivery management. During the neonatal period, the nurse should work to reduce stimulation, position to promote optimal interaction, educate the parents, and initiate follow-up care for continued developmental assessments. At this time, available data merely suggest associations between cocaine use and negative perinatal outcomes; they do not imply causal relationships. Because the adverse effects to the fetus and newborn are not conclusively documented in the literature, it can be difficult to educate the preconceptual or pregnant woman about the risks of cocaine use during pregnancy. Despite this obstacle, the nurse must use the information available to present as clear a picture as possible of the risks of exposing the fetus to cocaine.