One-Year Outcomes of Prenatal Exposure to MDMA and Other Recreational Drugs

Department of Environmental Health Sciences, Case Western Reserve University, Cleveland, Ohio 44106, USA.
PEDIATRICS (Impact Factor: 5.47). 08/2012; 130(3):407-13. DOI: 10.1542/peds.2012-0666
Source: PubMed


A widely used illicit recreational drug among young adults, 3,4-methylenedioxymethamphetamine (MDMA) or ecstasy, is an indirect monoaminergic agonist/reuptake inhibitor affecting the serotonin system. Preclinical studies found prenatal exposure related to long-term learning and memory impairments. There are no studies of sequelae of prenatal MDMA exposure in humans, despite potential harmful effects to the fetus.
A total of 96 women in the United Kingdom (28 MDMA users; 68 non-MDMA) were interviewed about recreational drug use during pregnancy. Their infants were seen at 12 months using standardized assessments of cognitive, language, and motor development (Preschool Language Scale, Bayley Mental and Motor Development and Behavior Rating Scales [Mental Development Index, Psychomotor Development Index, Behavioral Rating Scale]). Mothers completed the Child Domain Scale of the Parenting Stress Index, The Home Observation of the Environment Scale (in interview), the Brief Symptom Inventory, and the Drug Abuse Screening Test. Women were primarily middle class with some university education, in stable partner relationships, and polydrug users. MDMA and other drug effects were assessed through multiple regression analyses controlling for confounding variables, and analysis of covariance comparing heavier versus lighter and nonexposed groups.
Amount of prenatal MDMA exposure predicted poorer infant mental and motor development at 12 months in a dose-dependent manner. Heavily exposed infants were delayed in motor development. Lighter-exposed infants were comparable to nonexposed infants. There were no effects on language, emotional regulation, or parenting stress.
Findings document persistent neurotoxic effects of heavier prenatal MDMA exposure on motor development through the first year of life.

Download full-text


Available from: Lynn T Singer, Oct 05, 2015
34 Reads
  • Source
    • "Psychiatric symptoms were found to be associated with MDMA use ( e . g . Daumann et al . , 2001 ; Dughiero et al . , 2001 ; Singer et al . , 2012 ) , and especially with regular or problematic MDMA use ( e . g . Parrott et al . , 2000 ; Parrott et al . , 2001 ; Morgan et al . , 2002 ; Soar et al . , 2006 ) . The association between the severity of psychiatric symptoms and the frequency of cocaine use ( Velasquez et al . , 2007 ) and metamphetamine use ( Booth et al . , 2006 ; Mer"
    [Show abstract] [Hide abstract]
    ABSTRACT: In recent years, increasing intravenous mephedrone use was reported in several countries. The aim of this study was to describe the characteristics of such a form of mephedrone use, while identifying the differences between injectors and non-injectors in patterns of mephedrone use and psychiatric symptom status. One hundred and forty-five mephedrone users were surveyed on patterns of mephedrone use using a structured questionnaire as well as the Brief Symptom Inventory. Majority of users received mephedrone from acquaintances and used it in discos/parties settings regarding both first and current mephedrone use. Intranasal use was the most typical route of administration (84.4%). Injectors (11%) used the drug more frequently and in higher dosages. This group included a greater proportion of opiate users (37.5%) and showed more diffuse psychiatric symptoms. Regarding the predictors of being an injector, heroin use showed the highest odds ratio. Intravenous mephedrone use is associated with a higher risk of harmful drug use, elevated psychiatric symptom profile and increased possibility of mephedrone being considered as an addictive substance. These findings might be important in efficient treatment planning. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
    Human Psychopharmacology Clinical and Experimental 07/2015; 30(4):233-43. DOI:10.1002/hup.2490 · 2.19 Impact Factor
  • Source
    • "Laboratory animal studies show adverse effects of MDMA upon the developing foetus (Adori et al., 2010; Skelton et al., 2008), raising concerns about potentially damaging effects when taken by female recreational users during pregnancy. To date, there has been no controlled empirical data addressing this question , although there is some evidence of adverse birth consequences (McElhatton et al., 1999; Singer et al., 2012b). To investigate the potential effects of foetal MDMA exposure on development, the US National Institute on Drug Abuse (NIDA) funded the Drugs and Infancy Study (DAISY). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: The recreational drug MDMA (3,4-methylenedioxymethamphetamine) or 'Ecstasy' is associated with heightened psychiatric distress and feelings of depression. The Drugs and Infancy Study (DAISY) monitored the psychiatric symptom profiles of mothers who used Ecstasy/MDMA while pregnant, and followed them over the first year post-partum. Methods: We compared 28 young women whom took MDMA during their pregnancy with a polydrug control group of 68 women who took other psychoactive drugs while pregnant. The Brief Symptom Inventory (BSI) was completed for several periods: The first trimester of pregnancy; and 1, 4 and 12 months after childbirth. Recreational drug use was monitored at each time point. Results: During the first trimester of pregnancy, MDMA-using mothers reported higher depression scores than the polydrug controls. At 1 year after childbirth, their BSI depression scores were significantly lower, now closer to the control group values. At the same time point, their self-reported use of MDMA became nearly zero, in contrast to their continued use of Cannabis/marijuana, nicotine and alcohol. We found significant symptom reductions in those with BSI obsessive-compulsive and interpersonal sensitivity, following Ecstasy/MDMA cessation. Conclusions: The findings from this unique prospective study of young recreational drug-using mothers are consistent with previous reports of improved psychiatric health after quitting MDMA.
    Journal of Psychopharmacology 12/2013; 28(1). DOI:10.1177/0269881113515061 · 3.59 Impact Factor
  • Source
    • "On the other hand, enzyme systems that evolved to process small amounts of lowconcentration alcohol on an occasional basis may now be presented on a very regular basis with inexhaustible supplies of highly concentrated alcohol. These dramatic differences between the EEA and the new possibilities offered by technological advancement lead to a 'mismatch' between humans' evolved capabilities and the current technically modified environment (Singer et al., 2012). Traits, such as 'pharmacophagy', which conferred reproductive benefit in the EEA, may well lead to severely impaired reproductive fitness in the current environment. "
    [Show abstract] [Hide abstract]
    ABSTRACT: In this article, ontogenetic and phylogenetic causes of drug abuse and links to human emotional development are considered. Some evolutionary perspectives (e.g. that under certain conditions, consumption of otherwise toxic alkaloids may confer both physical and cultural advantages) are reviewed. As described in the 'mismatch theory', the capacity of the human genome to evolve defences against toxins has been outstripped by the pace of cultural change and technological development, such as purposeful fermentation of alcohol and more recently distillation of alcohol; purification and chemical manipulation of plant alkaloids; and the engineering of entirely novel psychoactive substances (NPS). The functions of the neurobiological substrates that mediate substance misuse and dependence are reviewed. Reasons are given why NPSs present greater cause for concern than plant-derived substances of abuse. We argue that evolutionary biology provides an important orientation for the research agenda in substance misuse. Copyright © 2013 John Wiley & Sons, Ltd.
    Human Psychopharmacology Clinical and Experimental 07/2013; 28(4):394-401. DOI:10.1002/hup.2303 · 2.19 Impact Factor
Show more