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




A Case-Control Study of Maternal Periconceptual and Pregnancy Recreational Drug Use and Fetal Malformation Using Hair Analysis - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Objective

Maternal 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.

Methods

In 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.

Results

Women 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.

Conclusions

We 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.



Autor: Anna L. David , Andrew Holloway, Louise Thomasson, Argyro Syngelaki, Kypros Nicolaides, Roshni R. Patel, Brian Sommerlad, Amie Wi

Fuente: http://plos.srce.hr/



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