"These results are important in that they suggest new approaches in birth defects," said Yazigi, a reproductive endocrinologist and infertility specialist. "It may not be only the mother. The father may have a lot to do with it."
This study has prompted Dr. Hallam Hurt, chairman of neonatology at Albert Einstein Medical Center, to consider expanding her study of 72 cocaine-using mothers to include a question about the father's drug use at the time of conception.
"There have been a lot of people - the grandmothers, most often - who ask me, 'What about the men?' It's an excellent question," said Hurt.
It's not a question that can be answered yet. Yazigi stressed further study should be done with animals before investigating a connection between a man's cocaine use at the time of conception and the child's developmental problems.
"This research wasn't meant to be the last word. It was meant to stimulate more research in this line," he said.
Previous studies have found that pups of drug-exposed animals are hyperactive and show subtle neurological abnormalities.
Yazigi, 38, is applying for research grants to look at cocaine's effect on animal pups. If this work supports the results announced today, he anticipated human studies in "three to four years - maybe sooner if results are overwhelming."
But Hurt doubted whether the results of human studies - no matter how dramatic - would give pause to drug users.
"We haven't seen a decrease in women's use of cocaine despite education about its dangers," she said. "With two people who have a stable relationship, maybe they'll say, 'We should do something.' But if they are addicts, they're thinking about where to get the next hit of crack. They're not thinking about an unborn child.
"It's one thing, if a woman is pregnant, to get her to stop using drugs
because it will be better for her and the unborn child. But this study is talking about drug use at conception, at the time of having sex."
In Philadelphia, one of every six babies is born with traces of cocaine, usually crack, in its blood. This means its mother smoked crack within hours of delivery.
Crack-exposed babies are often irritable. They may cry for hours. As they grow, they exhibit speech, hearing and learning delays. They may be hyperactive or show severe emotional problems.
Most mothers who see the damage done to their children by cocaine, feel tremendous remorse, said Ruth Banks, director of substance abuse treatment services at Charles R. Drew Mental Health Center in Logan. The center draws 60 women, mostly coke or crack addicts, for outpatient treatment.
"Women take on all of the guilt for what happens to the children," said Banks. "Women will continue to carry the guilt, even if the studies go on to show that male sperm is involved in developmental problems.
"But it might back society down as to how society perceives these women. It would be healthy for society to look at it as a two-way street, that men are also culpable."
To conduct his study, Yazigi incubated sperm with cocaine solutions of varying strengths and at varying temperatures, including as high as 98.6 degrees fahrenheit, normal body temperature.
The cocaine was radioactive so that it could be detected. Yazigi then examined the sperm and found that although the cocaine remained bound to it, the sperm's viability was unaffected.
The study, announced in today's edition of the Journal of the American Medical Association, was conducted by Yazigi at Washington University in St. Louis. He joined Temple's ob-gyn staff three months ago.