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Cocaine Use in Pregnancy: Physicians Urged to Look for Problem Where They Least Expect It

Andrew Skolnick
JAMA. 1990;264(3):306-309. doi:10.1001/jama.1990.03450030018003.
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THE PROBLEM of cocaine use during pregnancy is being ignored by too many physicians who think that drug abuse by pregnant women is a problem of minorities, urban populations, and lower-socioeconomic groups.

So says Ira J. Chasnoff, MD, associate professor of pediatrics and psychiatry at Northwestern University Medical School, Chicago, Ill. This presumption is not only wrong, but it may prevent physicians from identifying patients in need of help, he says.

Speaking at the 38th annual meeting of the American College of Obstetricians and Gynecologists (ACOG), in San Francisco, Chasnoff reported a study that suggests physicians with the "NIMO [Not In My Office] syndrome" are sadly mistaken. "The use of illicit drugs is common among pregnant women regardless of their race or socioeconomic status," he says.

In their study (N Engl J Med. 1990;322:1202-1206), Chasnoff and colleagues find little difference in the prevalence of substance use among women who received


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