In Reply.—

Dr Bays has pointed out that congenital limb reduction defects associated with prenatal exposure to cocaine may be quite common. I would agree that such limb and digital disruptions are occasional accompaniments of fetal exposure to maternal cocaine abuse. However, the exact magnitude of individual fetal risk for prenatal vascular disruption associated with such exposure remains to be delineated.

One must take the percentage of cocaine-exposed children in this report as the minimal number of exposed because many of the medical records did not record prenatal drug exposure.

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