PRENATAL COCAINE EXPOSURE AND THE DEVELOPMENT OF THE HUMAN EYE

Purpose: The use of cocaine during pregnancy has been associated with congenital abnormalities of the developing eye. The authors report a p rospective, controlled study of 40 cocaine-exposed and 40 nonexposed ( control) preterm and full-term infants. Methods: Detailed maternal and obstetric histories were obtained by chart review and interview. Infa nts with a positive urine toxicology screen for cocaine at birth or wh ose mothers tested positive for cocaine were recruited into the expose d group. Nonexposed infants were recruited at random from newborns adm itted to the authors' nurseries. Mothers of these infants received rou tine prenatal care in the authors' clinics, and nonexposure was docume nted by maternal history and/or negative urine toxicologies that were available in 30% of these mother-infant pairs. General physical and oc ular examinations, including measurement of axial length and intraocul ar pressure, were. performed on all infants. Results: Forty infants we re recruited in each group, with gestational ages ranging from 25 to 4 2 weeks. Twenty-nine of the exposed infants and 26 of the control infa nts were full-term (gestational age, 37 weeks or older). A total of 16 0 eyes were examined. No differences were seen in the incidence of con genital anomalies, subconjunctival hemorrhages, retinal hemorrhages, o r optic nerve abnormalities between the two groups. No differences in mean axial length (16.9 +/- 0.6 mm [exposed group] versus 17.1 +/- 0.7 mm [control group]) or intraocular pressure (15.4 +/- 3.8 mmHg [expos ed group] versus 15.0 +/- 3.0 mmHg [control group)] were seen between full-term infants in both groups. Axial length correlated strongly wit h gestational age, birth weight, head circumference, and body length o ver the range of gestational ages evaluated in both groups. No effect of cocaine exposure on these correlations was demonstrated. The range of axial length was 12.1 to 18.0 mm in the exposed group and 12.4 to 1 8.6 mm in the control group. Conclusion: In this study group, no signi ficant effect of prenatal cocaine exposure was seen on the infant eye. In both exposed and nonexposed groups, axial length measurements agre ed closely with known statistical norms and correlated closely with ot her parameters of fetal growth.