This article provides historical context on the study of prenatal drug expo
sure and child outcome, traces attention to the issue over time, discusses
prevalence approaches and estimates, characterizes studies of prenatal drug
exposure and child outcome, and examines research challenges and direction
s. Challenges and directions discussed are: determination of drug exposure,
with special attention to measuring levels of prenatal exposure and detect
ing postnatal passive exposure; assessment of child outcome, including comm
ents on neuroimaging; changes in drug use, with comment on current methamph
etamine concerns; human subjects issues; and study design and statistical a
nalysis considerations. The article also highlights some resources directly
relevant to providing services for drug-using pregnant women and their chi
ldren.