The traditional concern with drugs administered during pregnancy has been teratogenicity or the production of gross structural malformation. Within the last decade or so, it has become increasingly evident that the issue of drug-safety and risk assessment goes far beyond structural defects and has come to encompass a whole range of adverse outcomes that include neurobehavioral as well as other functional effects. Major licit and illicit drugs - cigarettes, marijuana, alcohol, the opioids, cocaine and phencyclidine - exemplifty this range of developmentally toxic outcomes. For example, women who smoke cirgarettes during pregnancy are at increased risk for complications of pregnancy and their offspring are likely to show growth retardation. Alcohol consumed regularly in heavy amounts during pregnancy, produces an array of structural and neurobehavioral effects known as the fetal alcohol syndrome. This includes craniofacial anomlies, developmental delays, and mild to severe mental retardation. Neither heroin nor methadone during pregnancy are associated with an increase in birth defects but both produce a neonatal abstinence syndrome that can perists for as long as six months. Follow-up to pre-school years suggests risk of attention deficit disorder. And while use of cocaine is growing at an alarming rate, little is known of its developmental toxicity. Preliminary findings, however, indicate both reproductive hazard and neurobehavioral effects in the neonate. Finally, there will be presentations on a number of drug abuse issues that include treatment, AIDS and infant outcome, legal and ethical considerations as well as government policy regarding child and maternal health.
