The childhood effects of antenatal exposure to cocaine are largely unknown. While several authors have evaluated the consequences of antenatal cocaine exposure during the neonatal period and early childhood, there are no large, blinded and systematic studies of the effects beyond early childhood and no data at early school age.

In the Netherlands, approximately 30% of all women of reproductive age smoke, compared with 36% of men.

Cigarette smoking is associated in women with a dose-related reduction in fecundity and fertility and in men with a reduction in semen quality. Smoking has a negative effect on pregnancy: increased rates of antepartum bleeding and placenta praevia have been described. Smoking is also associated with increases in the rates of spontaneous abortion, low birth weight and perinatal death. Some tobacco-related perinatal deaths are due to an increased risk of serious malformation. Children of mothers who smoke are admitted twice as often to hospital for pulmonary problems. However, studies on maternal smoking and childhood cancer have proved inconclusive.

A woman with heart disease may benefit from early obstetric counselling because it may help to reduce uncertainty or anxiety with regard to her ability to carry a pregnancy at some time in her life and may help her to prevent unwanted pregnancy or to avoid the need for an abortion. Pregnancy imposes an additional burden upon the circulation of a woman with heart disease and additional precautions may therefore be required during the antenatal period, labour, delivery and the puerperium. Nevertheless, with proper care, maternal and fetal outcome is good in most women with cardiac disease.

Much of our understanding of uteroplacental insufficiency has been derived from animal research and the study of the pathology of human placental and uterine biopsies. These studies have shown how the placenta plays a major role in the development of normal pregnancy and how placental dysfunction is generally caused by factors interfering with the normal growth of the uteroplacental and/or fetoplacental circulations. These abnormalities lead to a deficient supply of oxygen and nutrients to the fetus and to several complications of pregnancy such as gestational hypertension, preeclampsia and intrauterine growth retardation (IUGR).

The developmental origins of the ability to hear have been the subject of much debate and speculation. Since time immemorial, there has been much anecdotal evidence that the fetus responds to sound. In contrast, until the late 19th Century, scientific evidence and opinion held that the newborn was deaf and only developed the ability to hear in the first weeks after birth. At the beginning of the 20th Century the prevailing scientific and clinical view changed and it was accepted that the newborn was able to hear at birth. This led to much speculation about, and limited experimental study of, when the individual first started to hear. Detailed study of the ontogency of auditory abilities had to wait until the 1980’s when scientific opinion regarding the abilities of the newborn changed and the ultrasound technology with which to observe the fetus in utero became widely available. Research thus commenced in earnest to investigate the response of the fetus to sound. Despite this increased interest in fetal hearing, experimental studies have concentrated upon the responsiveness to sound in late pregnancy and not on the developmental origine of auditory abilities. It is the aim of this review to examine the ontogenesis of hearing in the fetus.