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Side effects smoking crack while pregnant. The effects of smoking crack while pregnant include heart attacks, respiratory failure, strokes and seizures. Other issues the fetus of someone who is pregnant and addicted to crack may have include having a smaller head, high risk of birth defects, issues in the urinary tract and heart problems. The Effects of Crack Cocaine on an Unborn Fetus. Using crack while pregnant can do extreme damage to a fetus. Studies published in the 1993 Southern Medical Journal suggest that as many as 10 percent of women use cocaine at some point during their pregnancy. Low Birth Weight.