Substance abuse during pregnancy is a critical public health concern associated with harmful maternal, fetal consequences and developmental disorders. Cocaine is one of the most common drugs involved in prenatal exposure, it is a sympathomimetic drug that induces vasoconstriction. We recently confirmed the presence of sympathetic fibers around blood vessels of human umbilical cords (UCs) from healthy newborns. It is unknown whether UCs innervation could be altered in pregnancies of cocaine users, and thus compromise maternal-filial blood flow. We evaluated the UCs innervation from newborns prenatally exposed to cocaine and compared it with healthy newborns. Immunohistochemical assays with anti-PGP9.5 and anti-TH identified a subpopulation of newborns from cocaine pregnant users with increased IR-PGP and -TH area surrounding the umbilical arteries. Reduced UCs arterial diameter was also found. Together, our results support the idea that direct vasoconstrictor effects on the umbilical vessels could take part in different conditions such as intrauterine-growth restriction, prematurity, low-birth-weight and subsequent developmental alterations. Ongoing investigations seek correlations between cocaineinduced increase in periarterial innervation and the clinical manifestations in newborns of cocaine users. Risk factors such as poly-consumption, gestational age and nutritional status are being evaluated. The establishment of associations between neurobiological and clinical variables will help us to understand the relationship between developmental disorders and prenatal drug use.