Prenatal exposure to cocaine and other drugs. Outcome at four to six years.

In a longitudinal, prospective study, 95 children born to mothers who used cocaine and other drugs during pregnancy and 75 matched, nonexposed children born to mothers who had no evidence of alcohol or illicit substance use during pregnancy were evaluated for cognitive and behavioral outcome at 6 years of age. Prenatal exposure to cocaine and other drugs had no direct effect on the child's cognitive outcome (measured as IQ), but it had an indirect effect as mediated through the home environment. However, prenatal exposure to cocaine and other drugs did have a direct effect on the child's behavioral characteristics at 4-6 years of age, with the home environment having little impact. This study helps us to understand the fragile interaction of biological and environmental factors affecting the cognitive and behavioral development of children prenatally exposed to cocaine and other drugs.

Mandating vitamin K prophylaxis for newborns in New York State.

New York State's infant deaths and hospitalizations attributed to hemorrhagic disease of the newborn and other neonatal hemorrhagic conditions were reviewed. In 65% of 34 deaths reviewed, vitamin K was not documented as given or was given only after the onset of hemorrhage. Vitamin K was not included in standing orders in any of 22 hospitals contacted. As a result of this review, vitamin K prophylaxis was made a mandatory newborn care procedure in the State Public Health Code.

Project CONNECT: an interagency partnership to confront new challenges facing at-risk women and children in New York City.

Project CONNECT is a New York State--New York City collaborative venture to facilitate access to, coordinate and expand the delivery of health and human services, during the perinatal period to women and children in the three areas of New York City with the highest rates of morbidity and mortality. Based on the concept of comprehensive case management, CONNECT coordinates diverse providers around existing resources. Services implemented by community-based case managers for families in need include: medical care, substance/alcohol abuse treatment, foster care preventive services, parent education, developmental assessment, screening and child care. The initial points of entry to CONNECT are specific hospitals within the three targeted neighborhoods. Additional points of entry, including other hospitals and prenatal care sites, are being added on an incremental basis. Enrollment in CONNECT is also enrollment in Medicaid and participants are eligible for Medicaid services. It is expected that the CONNECT program will result in improved birth and health outcomes for women and their children, reduction in chemical dependency and improved family preservation. The state and city agencies that created CONNECT hope that by working together, through a very specific interagency agreement monitored by the offices of the Governor and the Mayor, they will be able to reach those families who have many needs, but traditionally have been difficult to engage and keep involved in the service delivery system. The ultimate benefit will go to the family as a whole, particularly the children, both the newborns and their siblings.(ABSTRACT TRUNCATED AT 250 WORDS)

Black adolescent pregnancy: prevention and management.

In New York State, today and every day, 180 teenagers become pregnant. However, pregnancy in adolescents is not just a technical or demographic issue. It has cultural and practical dimensions. Nationally, unmarried black teenagers are five times more likely to give birth than white teenagers. In other words, one in every five nonwhite babies has a teenager for a mother! This has long-term societal consequences incalculable dimensions; and black leaders are increasingly concerned. It is recognized that sex-role socialization is an important component of personality development. Yet, few researchers have examined the unique situation of black girls in a society which denigrates both the female and the black role. As pluralistic as our society may be, and no matter how relevant cultural and subcultural values may be, it is an incontrovertible fact that, by exceedingly early childbearing, poor teenagers who are black immeasurably increase their inherent disadvantages to pursue education and acquire marketable skills, not to mention attractive jobs. On the other hand, more women in upper socio-economic categories are characteristically delaying, childbearing, and even marriage, into their thirties. The immediate and long-range consequences of unplanned teenage pregnancies are many. These include poverty, stress, suboptimal environment, nutritional inadequacy, and frequently, late or no prenatal care. Negative outcomes include low birthweight, prematurity, child abuse and development disability. There are, in addition, many delayed effects. Therefore, physicians and other health professionals must ensure that wanted pregnancies yield a healthy child. Young women and young men must be convinced that early childbearing will foreclose chances of a better socio-economic future for themselves and their progeny.(ABSTRACT TRUNCATED AT 250 WORDS)