The study found that at birth, infants exposed to cocaine during the mother's pregnancy were premature and lower in weight, length, and head circumference compared with infants who did not test positive for cocaine. Prenatal alcohol and tobacco use by the mother were also related to some of these effects at birth. These findings confirmed other research that found health risks for infants exposed to maternal cocaine use during pregnancy. Despite these neonatal health effects, however, the study did not find any significant link between an infant's exposure to prenatal maternal cocaine use and subsequent substantiated reports of the child's maltreatment. This finding contrasted with several other studies that have shown a relationship between prenatal cocaine exposure and subsequent maltreatment and foster care placement. Possible explanations for these differences are discussed. Of 8,913 infants born in a university-affiliated hospital over a 2-year period, 811 were selected for urine toxicology screening based on a documented or suspected maternal history of substance abuse of the condition of the mother and child at the time of delivery. Of the 811 infants tested, 100 were positive for cocaine, thus indicating maternal use of the drug prior to delivery. These infants were matched with 100 infants who had tested negative. The final sample used for comparison consisted of 76 infants who were cocaine-positive at birth and 76 who were not. Obstetrical and pediatric charts were used to obtain relevant demographic and health data. In addition, all infants were searched in the New York State Central Register of Child Abuse and Neglect for substantiated reports of maltreatment. 7 tables and 41 references