Effects of cocaine/polydrug exposure and maternal psychological distress on infant birth outcomes.
Singer LT, Salvator A, Arendt R, Minnes S, Farkas K, Kliegman R.
Department of Pediatrics, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA. firstname.lastname@example.org
To assess teratogenic effects of cocaine exposure and maternal psychological distress on birth outcomes, we conducted a longitudinal prospective study of 415 infants (218 cocaine-exposed--CE, 197 nonexposed--NE). Drug exposure was determined through a combination of maternal self-report, urine, and meconium screens. Maternal psychological distress postpartum was evaluated through a standardized, normative, self-report assessment. An extensive set of confounding variables was controlled, including severity of exposure to alcohol, tobacco, marijuana and other drugs, maternal age, race, parity, number of prenatal care visits, educational, marital, and socioeconomic status, and verbal and nonverbal intelligence. CE infants were smaller on all birth parameters and more likely to be preterm, small for gestational age, and microcephalic than NE infants. Forty-one percent of cocaine users had clinically significant psychological symptoms, compared to 20% of a high-risk comparison group of noncocaine users. Consistent with a teratologic model, cocaine exposure independently predicted offspring birthweight, length, and head circumference. Maternal psychological distress self-reported postnatally also independently predicted head circumference. Tobacco, alcohol, and marijuana exposures were also significant independent predictors of some fetal growth parameters. In addition, maternal distress symptoms, which may be reflective of maternal mental health disorders or responses to stress, added significantly to the risk for poorer fetal growth.
A population-based study of gastroschisis: demographic, pregnancy, and lifestyle risk factors.
Torfs CP, Velie EM, Oechsli FW, Bateson TF, Curry CJ.
California Birth Defects Monitoring Program, Emeryville 94608.
Gastroschisis, an abdominal wall defect, most often occurs in infants of young mothers. To identify risk factors for gastroschisis, we conducted a case-control study in the population surveyed by the California Birth Defects Monitoring Program (CBDMP). From structured questionnaire data, we compared sociodemographic, reproductive, and lifestyle factors for 110 mothers of infants with gastroschisis with those for 220 age-matched mothers of normal infants. Univariate matched-pair analysis showed significant associations of gastroschisis with mother's education, yearly family income, marital status, a history of mother's mother smoking, mother's father's absence from home during the mother's youth, more than one elective abortion, a short interval between menarche and first pregnancy, siblings from different fathers, and use of either a recreational drug (either cocaine, amphetamine, marijuana, or LSD), alcohol, or tobacco during the trimester preceding pregnancy. For cocaine, amphetamine, and marijuana, use of more than one drug showed a stronger association than single drug use. The association was stronger if both parents used drugs. Although many variables were correlated, odds ratios (OR) were significant (95% confidence intervals) in multivariate conditional logistic analysis for: yearly family income < $10,000 [OR = 4.34 (1.54, 12.22)] or $10,000-$49,999 [OR = 3.93 (1.43, 10.80)]; mother's mother's smoking status not known [OR = 3.99 (1.66, 9.56)]; mother's father's absence from home during her youth [OR = 3.11 (1.14, 8.46)]; and drug use by mother [OR = 2.21 (1.21, 4.03)], father [OR = 1.66 (1.02, 2.69)], or both [OR = 3.05 (1.48, 6.28)]. The best predictive model explained 32% of the deviance. Young, socially disadvantaged women with a history of substance use were at highest risk for a child with a gastroschisis.
Int J Addict 1990-91;25(1A):19-33 Related Articles, Links
Genetic effects of marijuana.
Zimmerman S, Zimmerman AM.
Division of Natural Science, Glendon College, York University, Toronto, Ontario, Canada.
Marijuana and its constitutive cannabinoids--tetrahydrocannabinol (THC), cannabinol (CBN), and cannabidiol (CBD)--markedly affect mammalian cells. Cytogenetic studies have revealed that cannabinoids induce chromosome aberrations in both in vivo and in vitro studies. These aberrations include chromosomal breaks, deletions, translocations, errors in chromosomal segregation, and hypoploidy, and are due to the clastogenic action of cannabinoids or to cannabinoid-induced disruption of mitotic events or both. Conflicting reports of the cytogenetic effects of cannabinoids are partially explained by the different experimental protocols, cell types, and animals used by investigators. Cannabinoids also suppress macromolecular synthesis (DNA, RNA, and protein) as well as reduce the level of histone gene expression. In general these studies show that cannabinoids are detrimental to the health of an individual.
Dev Pharmacol Ther 1985;8(2):141-8 Related Articles, Links
Abnormalities in offspring associated with prenatal marihuana exposure.
Qazi QH, Mariano E, Milman DH, Beller E, Crombleholme W.
5 newborn infants, whose mothers acknowledged steady use of marihuana prior to and during pregnancies, displayed symptoms of intrauterine growth retardation, neurological problems, and abnormal morphogenesis. These findings fit in with the experimental studies and surveys of pregnant human populations which have indicated that cannabis products have teratogenic potential, though rigorous proof must await further information.
Arch Ophthalmol 1978 Feb;96(2):282-4 Related Articles, Links
Multiple ocular anomalies associated with maternal LSD ingestion.
Chan CC, Fishman M, Egbert PR.
Severe ocular malformations, including microphthalmos, intraocular cartilage, cataract, persistent hyperplastic primary vitreous, and retinal dysplasia, occurred in a premature baby girl. The mother had ingested LSD during the first trimester of pregnancy. To our knowledge, this is the third case reported of ocular teratogenesis associated with maternal LSD ingestion. Further cases must be documented to establish an actual cause and effect relationship between the drug and the induced malformations.