Ho E, Karimi-Tabesh L, Koren G
Motherisk Program, Department of Pediatrics, Pharmacology, Pharmacy, Medicine, Medical Genetics, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, University of Toronto, 555 University Avenue, M5G 1X8, Toronto, ON, Canada.
Neurotoxicol Teratol. 2001 Nov-Dec;23(6):561-7. doi: 10.1016/s0892-0362(01)00178-7.
To determine the characteristics of pregnant women who use Ecstasy (3,4-methylenedioxymethamphetamine, MDMA), and to identify reproductive risk factors associated with this group of women. Prospective, observational study. Pregnant women who have contacted the Motherisk Alcohol and Substance Use Helpline at The Hospital for Sick Children, in Toronto, about exposure to drugs, chemicals, infection or radiation. All inquiries from December 1998 to October 2000 concerning pregnant women who reported use of MDMA, and control cases of women not exposed to MDMA selected within the same week of the MDMA callers. Age, maternal demographics, pregnancy characteristics, patterns of alcohol, tobacco, and illicit drug use, psychological/emotional status, sexually transmitted disease, MDMA method and pattern of use, and adverse drug reactions after ingestion of MDMA. The 132 pregnant women who used MDMA were significantly younger (mean 23.2 vs. 31.2 years, P<.0001), and had more unplanned pregnancies compared to 122 pregnant nonusers (84.2% vs. 54.3%, P<.05). MDMA users were also more likely to be single (57.0% vs. 18.3%, P<.001), and to be White (82.2% vs. 56.0%, P<.05). Comparably more MDMA users smoked cigarettes (53.8% vs. 19.7%, P<.0001), drank alcohol (66.4% vs. 37.3%, P<.0001), and had significantly more episodes of binge drinking during pregnancy (mean 2.12 vs. 0.05, P<.001). Illicit drugs such as cocaine, marijuana, methamphetamine, ketamine, gamma-hydroxy butyrate, and psilocybin were used more frequently among the MDMA sample. Over a third of MDMA users reported psychiatric/emotional problems, including 6.5% with a clinically diagnosed condition that was being treated with medication and/or counseling. Pregnant women who use MDMA tend to be young, single, and report psychological morbidity, and have a clustering of risk factors that may compromise the pregnancy and fetus. Smoking, heavy alcohol intake, and polydrug use, combined with a higher than expected rate of unplanned pregnancies, increases the risk of fetal exposure to potentially harmful substances. It is important to account for the range of confounding risk factors among women who use MDMA in order to define possible direct effects of MDMA in pregnancy.
确定使用摇头丸（3,4－亚甲基二氧甲基苯丙胺，MDMA）的孕妇的特征，并识别与该组女性相关的生殖风险因素。前瞻性观察性研究。已就药物、化学物质、感染或辐射暴露问题联系多伦多病童医院Motherisk酒精和物质使用帮助热线的孕妇。对1998年12月至2000年10月间所有关于报告使用MDMA的孕妇的咨询，以及在MDMA使用者来电当周内选取的未接触MDMA的女性对照病例进行研究。研究内容包括年龄、孕产妇人口统计学特征、妊娠特征、酒精、烟草和非法药物使用模式、心理/情绪状态、性传播疾病、MDMA使用方法和模式，以及摄入MDMA后的药物不良反应。132名使用MDMA的孕妇明显更年轻（平均23.2岁对31.2岁，P<0.0001），与122名未使用MDMA的孕妇相比，意外怀孕的比例更高（84.2%对54.3%，P<0.05）。MDMA使用者也更可能单身（57.0%对18.3%，P<0.001），且为白人（82.2%对56.0%，P<0.05）。相比之下，更多MDMA使用者吸烟（53.8%对19.7%，P<0.0001）、饮酒（66.4%对37.3%，P<0.0001），且孕期暴饮的次数明显更多（平均2.12次对0.05次，P<0.001）。在MDMA样本中，可卡因、大麻、甲基苯丙胺、氯胺酮、γ－羟基丁酸和裸盖菇素等非法药物的使用更为频繁。超过三分之一的MDMA使用者报告有精神/情绪问题，其中6.5%患有临床诊断疾病，正在接受药物治疗和/或咨询。使用MDMA的孕妇往往年轻、单身，报告有心理疾病，且存在一系列可能危及妊娠和胎儿的风险因素。吸烟、大量饮酒和多种药物使用，再加上意外怀孕率高于预期，增加了胎儿接触潜在有害物质的风险。考虑到使用MDMA的女性中存在的一系列混杂风险因素，对于确定MDMA在孕期可能产生的直接影响很重要。
