NEW YORK — In a fourth-floor intensive care unit of the Bronx-Lebanon Hospital Center, a dark-haired baby girl born prematurely struggles for her life.
When doctors were forced to deliver the child by Caesarean section, she experienced severe breathing problems and was in very poor condition. Her mother had gone into labor early after suffering bleeding and a ruptured placenta.
Before delivery, physicians asked if the mother used drugs. She admitted taking cocaine every day.
"When was the last time?" a resident asked.
"Last night," the mother answered.
"I wonder if she can take care of the baby?" a doctor checking the infant's heart and respiration rate pondered later. "I don't think so. She doesn't even ask for the baby. She doesn't even come to her baby. We have to pull her by the hand to come over to see her baby."
These babies are the tiniest victims of cocaine, easily held in one hand as they struggle for life under the clear plastic domes of their incubators.
As they toss and turn in their artificial wombs, every heartbeat and breath recorded by sophisticated monitoring equipment, these children often lie abandoned by their parents.
In the war against drugs, scenes of police officers with guns drawn crashing into houses, suspects sprawled against walls and being frisked, bloody bodies and drugs seized from ships and planes have become the grist of news.
But there is another front line in the fight against narcotics--neonatal intensive care units in places like the Bronx-Lebanon Hospital Center in a New York City neighborhood infected by crack, the cheap, rapidly addictive form of cocaine. At Bronx-Lebanon, every social problem imaginable arrives round-the-clock at the emergency room. On a recent day, nine of the 17 babies in Bronx-Lebanon's intensive care unit were born to cocaine addicts.
In big cities across the nation, including Los Angeles, increasingly disturbing reports are beginning to turn up of cocaine addiction being passed on by mothers to their newborns. Often these are premature babies with cocaine withdrawal symptoms superimposed on the already considerable problems of prematurity. Some New York City physicians grimly estimate that significant numbers of these cocaine infants in hospitals serving poor neighborhoods could also have AIDS.
"Everyone is overwhelmed," said Dr. Jing Ja Yoon, chief of Bronx-Lebanon's neonatal unit. "Recently, we see a lot of mothers who do not care. They are on cocaine, but nothing else matters. They do not want to see the baby sometimes. They don't care about their appearance, their health. They don't seek prenatal care. They don't care whether they are going to take back their babies or not."
The physician paused as she spoke in the staff lounge alongside the newborn intensive care unit. "These babies are our future. If your future starts with this, can you imagine?"
At Bronx-Lebanon, mirroring the experience of some other inner-city hospitals, the number of babies born to drug abusers has grown dramatically from 75 in 1982 to more than 260 in 1987. Since 1982, the hospital's pediatricians have treated almost 800 such infants.
In 1982, approximately a third of the drug-abusing mothers were cocaine addicts. Last year, the rate soared to 90%.
Physicians have found a high incidence among cocaine children of prematurity and low birth weight. Increased numbers of congenital malformations of the central nervous system, kidneys, joints and bones also have been observed. Doctors also are trying to determine whether cocaine may be responsible for some sudden infant deaths, even though the addiction symptoms generally clear rapidly.
Studies in some other hospitals concur with these findings and have shown an increase in stillbirths and spontaneous abortions among cocaine-abusing women.
The problem is being felt from coast to coast. At the Martin Luther King/Charles Drew Medical Center in South-Central Los Angeles, doctors also say there has been a greater incidence of babies born to mothers using cocaine. Some cocaine users have experienced stillbirths. Some of the babies who lived had withdrawal symptoms.
At Lincoln Hospital in the Bronx and at a hospital in Harlem, a joint study of 50 cocaine-using women showed not only a higher rate of congenital malformations and growth retardation among the babies of cocaine abusers: Immediately after using cocaine, several mothers suffered premature separation of the placenta from the uterus, and their babies were born dead. A study at Northwestern Memorial Hospital in Chicago showed that four women experienced the onset of labor immediately after injecting themselves with cocaine.