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

Anna L. David; Andrew Holloway; Louise Thomasson; Argyro Syngelaki; Kypros Nicolaides; Roshni R. Patel; Brian Sommerlad; Amie Wilson; William Martin; Lyn S. Chitty

doi:10.1371/journal.pone.0111038

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

Anna L. David^*, Andrew Holloway, Louise Thomasson, Argyro Syngelaki, Kypros Nicolaides, Roshni R. Patel, Brian Sommerlad, Amie Wilson, William Martin, Lyn S. Chitty

^*Corresponding author for this work

Birmingham Clinical Trials Unit

Research output: Contribution to journal › Article › peer-review

15 Citations (Scopus)

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, 95^thCI 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, 95^thCI 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, 95^th 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.

Original language	English
Article number	e111038
Journal	PLoS ONE
Volume	9
Issue number	10
DOIs	https://doi.org/10.1371/journal.pone.0111038
Publication status	Published - 31 Oct 2014

Bibliographical note

Funding Information:
We thank all the women who donated hair samples for this study. We thank Dr Paul Seed, Senior Lecturer in Medical Statistics, King's College London, for assistance with deprivation scores. We also thank Dr Paul Bassett, Biostatistics Group, Joint UCLH, UCL, RFH Biomedical Research and Dr Catherine James, Clinical Academic Training Fellow, UCL Institute for Women's Health for statistical advice. This work was undertaken at UCLH/UCL, who received a proportion of funding from the Department of Health NIHR Biomedical Research Centre's funding scheme. ALD was funded by a HEFCE Clinical Senior Lectureship Award. LSC is partially funded NHS Biomedical Research Centre funding and by Great Ormond Street Hospital Children's Charity. All researchers were independent from the funders.

Publisher Copyright:
© 2014 David et al.

ASJC Scopus subject areas

General Biochemistry,Genetics and Molecular Biology
General Agricultural and Biological Sciences
General

Access to Document

10.1371/journal.pone.0111038

Cite this

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title = "A case-control study of maternal periconceptual and pregnancy recreational drug use and fetal malformation using hair analysis",

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.",

author = "David, {Anna L.} and Andrew Holloway and Louise Thomasson and Argyro Syngelaki and Kypros Nicolaides and Patel, {Roshni R.} and Brian Sommerlad and Amie Wilson and William Martin and Chitty, {Lyn S.}",

note = "Funding Information: We thank all the women who donated hair samples for this study. We thank Dr Paul Seed, Senior Lecturer in Medical Statistics, King's College London, for assistance with deprivation scores. We also thank Dr Paul Bassett, Biostatistics Group, Joint UCLH, UCL, RFH Biomedical Research and Dr Catherine James, Clinical Academic Training Fellow, UCL Institute for Women's Health for statistical advice. This work was undertaken at UCLH/UCL, who received a proportion of funding from the Department of Health NIHR Biomedical Research Centre's funding scheme. ALD was funded by a HEFCE Clinical Senior Lectureship Award. LSC is partially funded NHS Biomedical Research Centre funding and by Great Ormond Street Hospital Children's Charity. All researchers were independent from the funders. Publisher Copyright: {\textcopyright} 2014 David et al.",

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language = "English",

volume = "9",

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T1 - A case-control study of maternal periconceptual and pregnancy recreational drug use and fetal malformation using hair analysis

AU - David, Anna L.

AU - Holloway, Andrew

AU - Thomasson, Louise

AU - Syngelaki, Argyro

AU - Nicolaides, Kypros

AU - Patel, Roshni R.

AU - Sommerlad, Brian

AU - Wilson, Amie

AU - Martin, William

AU - Chitty, Lyn S.

N1 - Funding Information: We thank all the women who donated hair samples for this study. We thank Dr Paul Seed, Senior Lecturer in Medical Statistics, King's College London, for assistance with deprivation scores. We also thank Dr Paul Bassett, Biostatistics Group, Joint UCLH, UCL, RFH Biomedical Research and Dr Catherine James, Clinical Academic Training Fellow, UCL Institute for Women's Health for statistical advice. This work was undertaken at UCLH/UCL, who received a proportion of funding from the Department of Health NIHR Biomedical Research Centre's funding scheme. ALD was funded by a HEFCE Clinical Senior Lectureship Award. LSC is partially funded NHS Biomedical Research Centre funding and by Great Ormond Street Hospital Children's Charity. All researchers were independent from the funders. Publisher Copyright: © 2014 David et al.

PY - 2014/10/31

Y1 - 2014/10/31

N2 - 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.

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

Abstract

Bibliographical note

ASJC Scopus subject areas

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