Illicit drug use may raise birth defect risk

Women who use recreational drugs like cocaine and ecstasy around the time of conception and early in pregnancy may boost the chances their infants will be born with a defective closure of the abdominal wall through which the intestines protrude - a condition called gastroschisis.

“Over recent decades, epidemiologic studies have reported a steady global increase in the birth prevalence of gastroschisis,” particularly among young mothers, Dr. Elizabeth S. Draper, of the University of Leicester, UK, and colleagues note in the American Journal of Epidemiology.

“The search for the reason(s) for this strong relation with young maternal age has driven research in this area.”

In a matched case-control study in three regions of the UK, the researchers identified 165 infants with gastroschisis born over a 32-month period. A total of 144 mothers and 432 controls were included in the study.

They found that use of street drugs in the first-trimester raised the risk of gastroschisis more than twofold. The risk was threefold higher with first-trimester use of drugs that constrict the blood vessels like cocaine, amphetamines, and ecstasy.

There was also an increased risk of gastroschisis in infants of mothers who used aspirin or smoked cigarettes during the first trimester, or who had a history of gynecologic infection or disease prior to the current pregnancy.

“The public health message from this study is to target these risk factors for reduction among young women before they become pregnant in order to prevent any further increase in the birth prevalence of gastroschisis,” Draper’s team concludes.

SOURCE: American Journal of Epidemiology, February 15, 2008.

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