Article (PDF Available)

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.

Full-text (PDF)

Available from: Lynn T Singer
  • Source
    • "The majority of studies that included gender as an IP (n = 32) found that girls scored 2–5 points higher than boys independent of the effects associated with the EOI (i.e., socio-demographic determinants, metals, parent-child interactions, prenatal diet, air pollutants, breastfeeding, synthetic chemicals, sleep duration, and drugs) (P(s)<0.05 [22, 23, 26, 27, 29, 40, 48, 51, 53, 54, 56, 58, 63, 70,75767778798081828384; P(s)>0.05 [30, 38, 41, 43, 62, 66, 71, 85– 87]). "
    [Show abstract] [Hide abstract] ABSTRACT: The etiology of a child's cognitive ability is complex, with research suggesting that it is not attributed to a single determinant or even a defined period of exposure. Rather, cognitive development is the product of cumulative interactions with the environment, both negative and positive, over the life course. The aim of this systematic scoping review was to collate evidence associated with children's cognitive health, including inherent factors as well as chemical and non-chemical stressors from the built, natural, and social environments. Three databases were used to identify recent epidemiological studies (2003-2013) that examined exposure factors associated with general cognitive ability in children. Over 100 factors were evaluated from 258 eligible studies. We found that recent literature mainly assessed the hypothesized negative effects of either inherent factors or chemical exposures present in the physical environment. Prenatal growth, sleep health, lead and water pollutants showed consistent negative effects. Of the few studies that examined social stressors, results consistently showed cognitive development to be influenced by both positive and negative social interactions at home, in school or the community. Among behavioral factors related to diet and lifestyle choices of the mother, breastfeeding was the most studied, showing consistent positive associations with cognitive ability. There were mostly inconsistent results for both chemical and non-chemical stressors. The majority of studies utilized traditional exposure assessments, evaluating chemical and non-chemical stressors separately. Collective evidence from a limited number of studies revealed that cumulative exposure assessment that incorporates multiple chemical and non-chemical stressors over the life course may unravel the variability in effect on cognitive development and help explain the inconsistencies across studies. Future research examining the interactions of multiple stressors within a child's total environment, depicting a more real-world exposure, will aid in understanding the cumulative effects associated with a child's ability to learn.
    Full-text · Article · Feb 2016 · PLoS ONE
  • Source
    • "The effects of MDMA could not be attributed to other drug or alcohol exposures nor to sociodemographic factors. Motor skill deficits/delays had been apparent as early as four months of age (Singer et al., 2012a) and also at 12 months, when the heavier MDMA-exposed cohort exhibited deficits in standing and walking progressions compared to non-exposed infants (Singer et al., 2012b), Thus, the current study indicates a pervasive and continuing deficit in motor skills over the first 2 years of life compared to lighter and non-exposed children. There were no effects on MDI. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Recreational use of 3,4 methylenedioxymethamphetamine (ecstasy, MDMA) is increasing worldwide. Its use by pregnant women causes concern due to potentially harmful effects on the developing fetus. MDMA, an indirect monoaminergic agonist and reuptake inhibitor, affects the serotonin and dopamine systems. Preclinical studies of fetal exposure demonstrate effects on learning, motor behavior, and memory. In the first human studies, we found prenatal MDMA exposure related to poorer motor development in the first year of life. In the present study we assessed the effects of prenatal exposure to MDMA on the trajectory of child development through 2years of age. We hypothesized that exposure would be associated with poorer mental and motor outcomes. Materials and methods: The DAISY (Drugs and Infancy Study, 2003-2008) employed a prospective longitudinal cohort design to assess recreational drug use during pregnancy and child outcomes in the United Kingdom. Examiners masked to drug exposures followed infants from birth to 4, 12, 18, and 24months of age. MDMA, cocaine, alcohol, tobacco, cannabis, and other drugs were quantified through a standardized clinical interview. The Bayley Scales (III) of Mental (MDI) and Motor (PDI) Development and the Behavior Rating Scales (BRS) were primary outcome measures. Statistical analyses included a repeated measures mixed model approach controlling for multiple confounders. Results: Participants were pregnant women volunteers, primarily white, of middle class socioeconomic status, average IQ, with some college education, in stable partner relationships. Of 96 women enrolled, children of 93 had at least one follow-up assessment and 81 (87%) had ≥ two assessments. Heavier MDMA exposure (M=1.3±1.4 tablets per week) predicted lower PDI (p<.002), and poorer BRS motor quality from 4 to 24months of age, but did not affect MDI, orientation, or emotional regulation. Children with heavier exposure were twice as likely to demonstrate poorer motor quality as lighter and non-exposed children (O.R.=2.2, 95%, CI=1.02-4.70, p<.05). Discussion: Infants whose mothers reported heavier MDMA use during pregnancy had motor delays from 4months to two years of age that were not attributable to other drug or lifestyle factors. Women of child bearing age should be cautioned about the use of MDMA and MDMA-exposed infants should be screened for motor delays and possible intervention.
    Full-text · Article · Jan 2016 · Neurotoxicology and Teratology
  • 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.
    Full-text · Article · Jul 2015 · Human Psychopharmacology Clinical and Experimental
Show more