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A case-control study of maternal periconceptual and pregnancy recreational drug use and fetal malformation using hair analysis.

David AL, Holloway A, Thomasson L, Syngelaki A, Nicolaides K, Patel RR, Sommerlad B, Wilson A, Martin W, Chitty LS - PLoS ONE (2014)

Bottom Line: Hair samples cut at the root were tested in sections corresponding to 3 month time periods (pre and periconceptual period).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).

View Article: PubMed Central - PubMed

Affiliation: Institute for Women's Health, University College London, and University College London Hospitals NHS Foundation Trust, London, United Kingdom.

ABSTRACT

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.

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Related in: MedlinePlus

Hair samples comprising approximately 50 hairs were cut at the level of the hair root.From there they were divided into three 3 cm segments, representing the three time periods of interest: periconceptual (prior to the month in which conception took place and during the month in which conception took place), 1st trimester (up to and including 12 weeks of gestation) and 2nd trimester (13 weeks of gestation onwards). In this example the hair sample was cut when the woman was at the end of the 2nd trimester, giving a 3 cm length of hair for each time period of study.
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pone-0111038-g001: Hair samples comprising approximately 50 hairs were cut at the level of the hair root.From there they were divided into three 3 cm segments, representing the three time periods of interest: periconceptual (prior to the month in which conception took place and during the month in which conception took place), 1st trimester (up to and including 12 weeks of gestation) and 2nd trimester (13 weeks of gestation onwards). In this example the hair sample was cut when the woman was at the end of the 2nd trimester, giving a 3 cm length of hair for each time period of study.

Mentions: The average rate of growth of hair is approximately 1 cm per month (range 0.75–1.5 cm); therefore, a 3-cm section of hair approximates to a three-month period [23]–[24]. Using this information and the gestational age at hair sampling, the timing of positive results was determined for each case and control and categorised into three groups periconceptual, 1st trimester and 2nd trimester (Figure 1). This method of analysis allows for the detection of drug use that occurred around the time that fetal organogenesis is being completed, when the development of a fetal structural anomaly may occur. The method of analysis, however, is not capable of reflecting exact drug doses taken, or the exact time point within the three-month period that drugs were used. For all analysed cases and controls, there was a hair sample available for the equivalent periconceptual and trimester time period, even for those women recruited in the late third trimester.


A case-control study of maternal periconceptual and pregnancy recreational drug use and fetal malformation using hair analysis.

David AL, Holloway A, Thomasson L, Syngelaki A, Nicolaides K, Patel RR, Sommerlad B, Wilson A, Martin W, Chitty LS - PLoS ONE (2014)

Hair samples comprising approximately 50 hairs were cut at the level of the hair root.From there they were divided into three 3 cm segments, representing the three time periods of interest: periconceptual (prior to the month in which conception took place and during the month in which conception took place), 1st trimester (up to and including 12 weeks of gestation) and 2nd trimester (13 weeks of gestation onwards). In this example the hair sample was cut when the woman was at the end of the 2nd trimester, giving a 3 cm length of hair for each time period of study.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4215921&req=5

pone-0111038-g001: Hair samples comprising approximately 50 hairs were cut at the level of the hair root.From there they were divided into three 3 cm segments, representing the three time periods of interest: periconceptual (prior to the month in which conception took place and during the month in which conception took place), 1st trimester (up to and including 12 weeks of gestation) and 2nd trimester (13 weeks of gestation onwards). In this example the hair sample was cut when the woman was at the end of the 2nd trimester, giving a 3 cm length of hair for each time period of study.
Mentions: The average rate of growth of hair is approximately 1 cm per month (range 0.75–1.5 cm); therefore, a 3-cm section of hair approximates to a three-month period [23]–[24]. Using this information and the gestational age at hair sampling, the timing of positive results was determined for each case and control and categorised into three groups periconceptual, 1st trimester and 2nd trimester (Figure 1). This method of analysis allows for the detection of drug use that occurred around the time that fetal organogenesis is being completed, when the development of a fetal structural anomaly may occur. The method of analysis, however, is not capable of reflecting exact drug doses taken, or the exact time point within the three-month period that drugs were used. For all analysed cases and controls, there was a hair sample available for the equivalent periconceptual and trimester time period, even for those women recruited in the late third trimester.

Bottom Line: Hair samples cut at the root were tested in sections corresponding to 3 month time periods (pre and periconceptual period).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).

View Article: PubMed Central - PubMed

Affiliation: Institute for Women's Health, University College London, and University College London Hospitals NHS Foundation Trust, London, United Kingdom.

ABSTRACT

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.

Show MeSH
Related in: MedlinePlus