With the increasing use of cocaine in the U.S. population, women of childbearing age have particularly shown an increasing prevalence of use. In an ongoing study at the Perinatal Center for Chemical Dependence (PCCD) at Northwestern University Medical School, 70 infants delivered to cocaine-using women were evaluated. Pregnancy and neonatal outcome were compared to a group of drug-free controls who had no history of evidence of licit or illicit drug use. These controls were selected on the basis of social, demographic, and environmental backgrounds and were comparable for cigarette use during pregnancy. The cocaine-addicted women had a high incidence of pregnancy complications, and infants born to cocaine-using women demonstrated an increased rate of intrauterine growth retardation, prematurity, microcephaly, and perinatal morbidity. Further research will begin. to focus not only on the effects of cocaine per se, but also on the interactive effects of polydrug use, the dynamics of maternal/infant interaction in the substance abusing mother, and the environmental factors that place cocaine exposed infants at high risk for future medical and developmental disabilities.