A Case-Control Study of Maternal Periconceptual and Pregnancy Recreational Drug Use and Fetal Malformation Using Hair Analysis

Abstract

ObjectiveMaternal recreational drug use may be associated with the development of fetal malformations such as gastroschisis, brain and limb defects, the aetiology due to vascular disruption during organogenesis. Using forensic hair analysis we reported evidence of recreational drug use in 18% of women with a fetal gastroschisis. Here we investigate this association in a variety of fetal malformations using the same method.MethodsIn a multi-centre study, women with normal pregnancies (controls) and those with fetal abnormalities (cases) gave informed consent for hair analysis for recreational drug metabolites using mass spectrometry. Hair samples cut at the root were tested in sections corresponding to 3 month time periods (pre and periconceptual period).ResultsWomen whose fetus had gastroschisis, compared to women with a normal control fetus, were younger (mean age 23.78±SD4.79 years, 18–37 vs 29.79±SD6 years, 18–42, p = 0.00001), were more likely to have evidence of recreational drug use (15, 25.4% vs 21, 13%, OR2.27, 95thCI 1.08–4.78, p = 0.028), and were less likely to report periconceptual folic acid use (31, 53.4% vs 124, 77.5%, OR0.33, 95thCI 0.18–0.63, p = 0.001). Age-matched normal control women were no less likely to test positive for recreational drugs than women whose fetus had gastroschisis. After accounting for all significant factors, only young maternal age remained significantly associated with gastroschisis. Women with a fetus affected by a non-neural tube central nervous system (CNS) anomaly were more likely to test positive for recreational drugs when compared to women whose fetus was normal (7, 35% vs 21, 13%, OR3.59, 95th CI1.20–10.02, p = 0.01).ConclusionsWe demonstrate a significant association between non neural tube CNS anomalies and recreational drug use in the periconceptual period, first or second trimesters, but we cannot confirm this association with gastroschisis. We confirm the association of gastroschisis with young maternal age.

Broad Spectrum Epidemiological Contribution of Cannabis and Other Substances to the Teratological Profile of Northern New South Wales: Geospatial and Causal Inference Analysis

“…3.45-4.91) [4,[25][26][27][28][29][30]. Our ndings PR=5.85 (3.54-9.67) contradict those of a 2011 NSW Health report on gastroschisis in this region [31] which erroneously applied an in ated Bonferroni correction to obviate a signi cant result.…”

Broad Spectrum Epidemiological Contribution of Cannabis, Tobacco and Alcohol to the Teratological Profile of Northern New South Wales: Geospatial and Causal Inference Analysis

“…3.45-4.91) [4,[23][24][25][26][27][28]. Our ndings PR = 5.85 (3.54-9.67) contradict those of a 2011 NSW Health report on gastroschisis in this region [29] which erroneously applied an in ated Bonferroni correction to obviate a signi cant result.…”

Lifestyle and sociodemographic risk factors for gastroschisis: a systematic review and meta-analysis

“…Of these, 123 studies met the inclusion criteria (figure 1). Fifty-eight studies11 24–80 concerning lifestyle and sociodemographic risk factors were included in the systematic review (online supplementary tables S1-S2). Twenty-nine studies11 29 32 34 37 38 40 41 46 48–51 53–55 59 60 62–66 69 73–75 79 80 were available for meta-analyses comprising 21 994 cases of gastroschisis.…”