[Cocaine toxicity in the newborn. Detection and prevalence]

The neonatal effects of fetal cocaine exposure are not completely known. Serious adverse effects have been described in several series of women consuming pure cocaine, but in recent years articles questioning some of the damaging effects of cocaine on the fetus and newborn have been published. The use of cocaine is currently increasing both in Spain and in many other countries and this will in turn lead to an increase in the incidence of fetal and neonatal adverse effects. We review the possible effects of cocaine exposure in utero, and place particular emphasis on neurobehavioral abnormalities, which are present even when exposure is limited to the first trimester of pregnancy. We also analyze various biomarkers for cocaine detection in newborns and their mothers and, finally, we review pharmacogenetic and dose-response relation susceptibility factors.