Cocaine-positive urine toxicology at birth in 51 newborns was associated with hypertonia during infancy in 21(41%) studied at the Harlem Hospital Center, New York. Cocaine-positive infants were four times more likely to show hypertonic tetraparesis than cocaine-negative infants. Hypertonia diminished over time and resolved by 24 months. Those with early hypertonia showed significantly lower developmental scores at 6 and 12 months than infants without hypertonia. 
COMMENT. In our clinic for children with Attention Deficit Disorders at Children’s Memorial Hospital, Chicago, I have observed an unusual incidence of a history of fetal cocaine exposure in those placed in foster homes soon after birth. Other complications of cocaine exposure in utero are small head circumference, cerebral infarction or hemorrhage, seizures, and SIDS. Disturbances in corticogenesis have been demonstrated in experiments on laboratory animals (see Progress in Pediatric Neurology I and II, PNB Publishers, 1991, pp452-3, and 1994, pp439-41).