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Singer, Lynn T.; Moore, Derek G.; Min, Meeyoung O.; Goodwin, Julia; Turner, John J.D.; Fulton, Sarah; Parrott, Andrew C. (2016)
Publisher: Elsevier
Languages: English
Types: Article
Subjects: BF, Article
Background\ud \ud 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 2 years of age. We hypothesized that exposure would be associated with poorer mental and motor outcomes.\ud Materials and Methods\ud \ud 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 24 months 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.\ud Results\ud \ud 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 24 months 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).\ud Discussion\ud \ud Infants whose mothers reported heavier MDMA use during pregnancy had motor delays from 4 months 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.
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    • aCase Western Reserve University, 10900 Euclid Avenue, CCleveland, Ohio 44106, United
    • University of East London, Docklands Campus, University Way, London E16 2RD, United
    • University, Singleton Park, Swansea, Wales SA2 8PP, United Kingdom,
    • AdEelbert Hall, Room 216
    • C2040 Adelbert Road
    • ACCleveland, Ohio 44106
    • Telephone: 01 (216) 368-4389
    • FAX: 01 (216) 368-4325
    • Jacobs BL, & Fornal CA. (1995). Serotonin and behaviour: A general hypothesis. In K. D. Bloom
    • FE (Ed.), Psychopharmacology (pp. 461-469). New York: Raven Press Ltd. Mohan J ed. (June, 2014). World drug report 2014. ( No. ISBN 978-92-1-056752-7 - pp. 2, 3,
    • 123-152). Vienna, Austria: United Nations Office on Drugs and Crime. Ricaurte GA, Yuan J, & McCann UD. (2000). (+/-)3,4-methylenedioxymethamphetamine
    • ('ecstasy')-induced serotonin neurotoxicity: Studies in animals. Neuropsychobiology, 42(1),
    • 5-10. doi:26664 [pii] Singer LT, Moore DG, Min MO, Goodwin J, Turner JJD, Fulton S, & et al. (2012b). One-year
    • outcomes of prenatal exposure to MDMA and other recreational drugs. Pediatrics, 130(3),
    • 407-413. doi:10.1542/peds.2012-0666
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