While the cocaine-exposed children and a group of nonexposed controls performed about the same on tests, both groups lagged on developmental and intellectual measures compared to the norm. But after a time "we began to ask, 'Was there something else going on?' " "We went looking for the effects of cocaine," Hurt said. When it came to school readiness at age 6, about 25 percent of children in each group scored in the abnormal range on tests for math and letter and word recognition. Both numbers are well below the average of 90 to 109 for U.S. At age 4, for instance, the average IQ of the cocaine-exposed children was 79.0 and the average IQ for the nonexposed children was 81.9. The researchers consistently found no significant differences between the cocaine-exposed children and the controls. Their mothers agreed to be tested for drug use throughout the study. The babies were then evaluated periodically, beginning at six months and then every six or 12 months on through young adulthood. Hurt's study enrolled only full-term babies so the possible effects of prematurity did not skew the results. On top of that, a parent's drug use can create a chaotic home life for a child. Babies born prematurely, no matter the cause, are at risk for a host of medical and developmental problems. The drug can cause a problematic rise in a pregnant woman's blood pressure, trigger premature labor, and may be linked to a dangerous condition in which the placenta tears away from the uterine wall. Hurt, who is also a professor of pediatrics at the University of Pennsylvania, is always quick to point out that cocaine can have devastating effects on pregnancy. She looked like a porcelain doll," Karen Drakewood, now 51, said recently in her Overbrook kitchen.
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She was on an all-night crack binge in a drug house near her home in the city's West Oak Lane section when she went into labor. One mother who signed up was Jaimee's mom, Karen Drakewood. But she never anticipated that the study, funded by the National Institute on Drug Abuse, would become one of the largest and longest-running studies of in-utero cocaine exposure. Hurt hoped the study would inform doctors and nurses caring for cocaine-exposed babies and even guide policies for drug prevention, treatment, and follow-up interventions. All the babies came from low-income families, and nearly all were African Americans. It was amid that climate that Hurt organized a study of 224 near-term or full-term babies born at Einstein between 19 - half with mothers who used cocaine during pregnancy and half who were not exposed to the drug in utero. The "crack baby" image became symbolic of bad mothering, and some cocaine-using mothers had their babies taken from them or, in a few cases, were arrested. Some social workers predicted a lost generation - kids with a host of learning and emotional deficits who would overwhelm school systems and not be able to hold a job or form meaningful relationships. Worse, the babies seemed aloof and avoided eye contact. They had small heads and were easily agitated and prone to tremors and bad muscle tone, according to reports, many of which were anecdotal. Troubling stories were circulating about the so-called crack babies. A 1989 study in Philadelphia found that nearly one in six newborns at city hospitals had mothers who tested positive for cocaine. In maternity wards in Philadelphia and elsewhere, caregivers were seeing more mothers hooked on cheap, smokable crack cocaine. A crack epidemic was raging in Philadelphia in 1989 when Hallam Hurt, then chair of neonatology at Albert Einstein Medical Center on North Broad Street, began a study to evaluate the effects of in-utero cocaine exposure on babies.
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