Motor delays in MDMA (ecstasy) exposed infants persist to 2years

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 2 years 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 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. 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 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). Discussion 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.

Ketamine administered pregnant rats impair learning and memory in offspring via the CREB pathway

“…Consensus is that fetal exposure to alcohol is harmful. Prenatal alcohol exposure may induce abnormal brain development as well as decrease the capacity for learning and memory [12, 13]. Similar to alcohol, anticonvulsants, sedatives (such as ketamine), or narcotics can pass through the placental barrier and for ketamine in particular, researches showed its ability to impair the capacity for learning and memory [14, 15].…”

Neuropsychomotor development characteristics of the infants who born from women who abused drugs during pregnancy

“…In the United Kingdom, in a longitudinal study evaluating infants, children of women using recreational drugs (ecstasy) during pregnancy, from birth to 4, 12, 18 and 24 months of age, it was shown that exposure (greater use of tablets per week) resulted in worse motor development, but without affecting mental development. These infants with more intense exposure were twice as likely to demonstrate poorer quality of motor performance than the non-exposed ones 13 .…”

“…A retrospective study of children who were pregnant with crack and cocaine during the first days of life showed abnormalities in 34.9% of the study population 14 . The changes detected were subependymal cysts in 24 children (18.6%), lentricular vascular disease in 18 children (14%), subependymal haemorrhage in 9 children (7%) and choroid plexus cysts in 9 children (7%) 13 . Dixon and Bejar 15 , in a study of full-term new-borns exposed to cocaine and methamphetamine and evaluated by cranial ultrasonography, also identified lesions such as intraventricular haemorrhage, necrosis and cavitary lesions in the basal ganglia, frontal lobes, and posterior fossa.…”

Clinical and Medical Management of Conditions Caused by MDMA or ‘Ecstasy’

“…With the group comparisons, the more heavily MDMA-exposed neonates had significantly lower 'motor quality' scores at four months post-partum , and these psychomotor deficits remained significant at the 12-and 24-month post-partum sessions Singer et al, 2015). These findings need to be replicated, and the effects of MDMA on male sperm need to be studied.…”