Many drug-abusing women fail to obtain adequate prenatal care, and are predisposed to various obstetrical and medical problems that affect the morbidity and mortality of their infants at birth. Common obstetrical complications associated with heroin addiction include abortion, abruptio placentae, amnionitis, and chorioamnionitis. Babies of addicted mothers are also at higher risk of various birth traumas and congenital abnormalities. Neonates born to addicted mothers were on the average, small for gestational age with low birthweight and small head circumference. They often go through withdrawal symptoms after birth, and have a much higher incidence of sudden infant death syndrome than their counterparts born to nonaddicted mothers. The article also discusses cognitive and motor deficits seen in toddler and preschool-aged children of heroin- and methadone-addicted mothers. The article concludes with several policy and research recommendations. 11 references