Cocaine is a tropane alkaloid with local anaesthetic and CNS stimulant properties. Cocaine is legitimately (though rarely) used as a topical local anaesthetic and illicitly as a drug of abuse. Cocaine is mainly abused by insufflation (snorting) but it can also be injected, smoked or ingested. It causes acute vasoconstriction which may cause fetal haemorrhage and hypoxia. Its use is contraindicated in pregnancy.
Data on cocaine use is heavily confounded, however cocaine use during pregnancy has been associated with increased risk of spontaneous abortion, placental abruption, premature labour, intrauterine growth retardation and Sudden Infant Death Syndrome (SIDS). The teratogenicity of cocaine is not confirmed, however malformations observed in infants after prenatal cocaine exposure include microcephaly and malformations of the skeletal system, nervous system, gastrointestinal tract, genitourinary system and cardiovascular system. Exposure in late pregnancy may lead to neonatal withdrawal in the infant.
Exposure to cocaine at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy but may warrant enhanced antenatal surveillance of fetal growth and development.
This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to NHS health care professionals who are logged in.
If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.
If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.