Department of Environmental Health Sciences, Case Western Reserve University, Cleveland, Ohio 44106, USA.
Pediatrics. 2012 Sep;130(3):407-13. doi: 10.1542/peds.2012-0666. Epub 2012 Aug 20.
A widely used illicit recreational drug among young adults, 3,4-methylenedioxymethamphetamine (MDMA) or ecstasy, is an indirect monoaminergic agonist/reuptake inhibitor affecting the serotonin system. Preclinical studies found prenatal exposure related to long-term learning and memory impairments. There are no studies of sequelae of prenatal MDMA exposure in humans, despite potential harmful effects to the fetus.
A total of 96 women in the United Kingdom (28 MDMA users; 68 non-MDMA) were interviewed about recreational drug use during pregnancy. Their infants were seen at 12 months using standardized assessments of cognitive, language, and motor development (Preschool Language Scale, Bayley Mental and Motor Development and Behavior Rating Scales [Mental Development Index, Psychomotor Development Index, Behavioral Rating Scale]). Mothers completed the Child Domain Scale of the Parenting Stress Index, The Home Observation of the Environment Scale (in interview), the Brief Symptom Inventory, and the Drug Abuse Screening Test. Women were primarily middle class with some university education, in stable partner relationships, and polydrug users. MDMA and other drug effects were assessed through multiple regression analyses controlling for confounding variables, and analysis of covariance comparing heavier versus lighter and nonexposed groups.
Amount of prenatal MDMA exposure predicted poorer infant mental and motor development at 12 months in a dose-dependent manner. Heavily exposed infants were delayed in motor development. Lighter-exposed infants were comparable to nonexposed infants. There were no effects on language, emotional regulation, or parenting stress.
Findings document persistent neurotoxic effects of heavier prenatal MDMA exposure on motor development through the first year of life.
3,4-亚甲二氧基甲基苯丙胺（MDMA，摇头丸）是一种在年轻人中广泛使用的非法娱乐性药物，它是一种间接的单胺能激动剂/再摄取抑制剂，影响着 5-羟色胺系统。临床前研究发现，产前暴露与长期学习和记忆损伤有关。尽管对胎儿有潜在的有害影响，但人类尚未对产前 MDMA 暴露的后遗症进行研究。
英国共有 96 名女性（28 名 MDMA 使用者；68 名非 MDMA 使用者）接受了关于怀孕期间娱乐性药物使用的访谈。他们的婴儿在 12 个月时接受了认知、语言和运动发育的标准化评估（学前语言量表、贝利心理和运动发育量表[心理发育指数、运动发育指数、行为评定量表]）。母亲完成了父母压力指数的儿童域量表、家庭观察环境量表（访谈）、简明症状量表和药物滥用筛查测试。这些女性主要来自中产阶级，接受过一些大学教育，处于稳定的伴侣关系中，且为多药使用者。通过多元回归分析控制混杂变量，并通过协方差分析比较重度和轻度暴露组与未暴露组，评估 MDMA 和其他药物的影响。
产前 MDMA 暴露量与 12 个月时婴儿的精神和运动发育呈剂量依赖性下降。重度暴露的婴儿运动发育迟缓。轻度暴露的婴儿与未暴露的婴儿相似。语言、情绪调节或育儿压力均无影响。
研究结果表明，通过 1 岁前的研究，发现了更大量的产前 MDMA 暴露对运动发育的持续神经毒性影响。
