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Hoffman MC, Hunter SK, D’Alessandro A, Noonan K, Wyrwa A, Freedman R. Interaction of maternal choline levels and prenatal Marijuana's effects on the offspring. Psychol Med 2020; 50:1716-1726. [PMID: 31364525 PMCID: PMC7055467 DOI: 10.1017/s003329171900179x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study investigated whether higher maternal choline levels mitigate effects of marijuana on fetal brain development. Choline transported into the amniotic fluid from the mother activates α7-nicotinic acetylcholine receptors on fetal cerebro-cortical inhibitory neurons, whose development is impeded by cannabis blockade of their cannabinoid-1(CB1) receptors. METHODS Marijuana use was assessed during pregnancy from women who later brought their newborns for study. Mothers were informed about choline and other nutrients, but not specifically for marijuana use. Maternal serum choline was measured at 16 weeks gestation. RESULTS Marijuana use for the first 10 weeks gestation or more by 15% of mothers decreased newborns' inhibition of evoked potentials to repeated sounds (d' = 0.55, p < 0.05). This effect was ameliorated if women had higher gestational choline (rs = -0.50, p = 0.011). At 3 months of age, children whose mothers continued marijuana use through their 10th gestational week or more had poorer self-regulation (d' = -0.79, p < 0.05). This effect was also ameliorated if mothers had higher gestational choline (rs = 0.54, p = 0.013). Maternal choline levels correlated with the children's improved duration of attention, cuddliness, and bonding with parents. CONCLUSIONS Prenatal marijuana use adversely affects fetal brain development and subsequent behavioral self-regulation, a precursor to later, more serious problems in childhood. Stopping marijuana use before 10 weeks gestational age prevented these effects. Many mothers refuse to cease use because of familiarity with marijuana and belief in its safety. Higher maternal choline mitigates some of marijuana's adverse effects on the fetus.
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Affiliation(s)
- M. Camille Hoffman
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA
- Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA
| | - Sharon K. Hunter
- Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA
| | - Angelo D’Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA
| | - Kathleen Noonan
- Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA
| | - Anna Wyrwa
- Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA
| | - Robert Freedman
- Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA
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Sebastiani G, Borrás-Novell C, Casanova MA, Pascual Tutusaus M, Ferrero Martínez S, Gómez Roig MD, García-Algar O. The Effects of Alcohol and Drugs of Abuse on Maternal Nutritional Profile during Pregnancy. Nutrients 2018; 10:E1008. [PMID: 30072661 PMCID: PMC6116049 DOI: 10.3390/nu10081008] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 07/24/2018] [Accepted: 08/01/2018] [Indexed: 02/06/2023] Open
Abstract
The consumption of alcohol and drugs of abuse among pregnant women has experienced a significant increase in the last decades. Suitable maternal nutritional status is crucial to maintain the optimal environment for fetal development but if consumption of alcohol or drugs of abuse disrupt the intake of nutrients, the potential teratogenic effects of these substances increase. Despite evidence of the importance of nutrition in addicted pregnant women, there is a lack of information on the effects of alcohol and drugs of abuse on maternal nutritional status; so, the focus of this review was to provide an overview on the nutritional status of addicted mothers and fetuses. Alcohol and drugs consumption can interfere with the absorption of nutrients, impairing the quality and quantity of proper nutrient and energy intake, resulting in malnutrition especially of micronutrients (vitamins, omega⁻3, folic acid, zinc, choline, iron, copper, selenium). When maternal nutritional status is compromised by alcohol and drugs of abuse the supply of essential nutrients are not available for the fetus; this can result in fetal abnormalities like Intrauterine Growth Restriction (IUGR) or Fetal Alcohol Spectrum Disorder (FASD). It is critical to find a strategy to reduce fetal physical and neurological impairment as a result of prenatal alcohol and drugs of abuse exposure combined with poor maternal nutrition. Prenatal nutrition interventions and target therapy are required that may reverse the development of such abnormalities.
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Affiliation(s)
- Giorgia Sebastiani
- Neonatology Unit, Hospital Clinic-Maternitat, ICGON, BCNatal, C/Sabino Arana 1, 08028 Barcelona, Spain.
| | - Cristina Borrás-Novell
- Neonatology Unit, Hospital Clinic-Maternitat, ICGON, BCNatal, C/Sabino Arana 1, 08028 Barcelona, Spain.
| | - Miguel Alsina Casanova
- Neonatology Unit, Hospital Clinic-Maternitat, ICGON, BCNatal, C/Sabino Arana 1, 08028 Barcelona, Spain.
| | - Mireia Pascual Tutusaus
- Neonatology Unit, Hospital Clinic-Maternitat, ICGON, BCNatal, C/Sabino Arana 1, 08028 Barcelona, Spain.
| | - Silvia Ferrero Martínez
- Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu, 08028 Barcelona, Spain.
| | - María Dolores Gómez Roig
- Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu, 08028 Barcelona, Spain.
| | - Oscar García-Algar
- Neonatology Unit, Hospital Clinic-Maternitat, ICGON, BCNatal, C/Sabino Arana 1, 08028 Barcelona, Spain.
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Sayadi MA, Achour O, Ezzaher A, Hellara I, Omezzine A, Douki W, Bousslama A, Gaha L, Najjar MF. CT genotype of 5,10-methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism is protector factor of major depressive disorder in the Tunisian population: a case control study. Ann Gen Psychiatry 2016; 15:18. [PMID: 27478487 PMCID: PMC4967526 DOI: 10.1186/s12991-016-0103-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 06/29/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a common psychiatric disorder with considerable mortality. Death from unnatural causes, largely suicidal or quasi-suicidal, has a particularly high risk for the functional disorders, especially depression and schizophrenia. One of the prospective risk factors for this disease is hyperhomocysteinemia and folate deficiency. The methylenetetrahydrofolate reductase (MTHFR) gene encodes for a 5-methylenetetrahydrofolate reductase involved in folate metabolism and neurotransmitter synthesis. The aim of this research is to study the association between the C677T polymorphism of MTHFR gene and depression in Tunisian population, to explore their relationship with clinical and therapeutic characteristics of this disease. And it may lead to discover a novel marker to identify a patient with a higher risk of development of depressive disorder to be. This marker can be used for better therapeutic management and prevent disease installation. METHODS Our study included 208 depressive patients, 187 controls aged between 44.1 ± 13.5 and 38.9 ± 13.2 years, respectively. MTHFR gene polymorphisms were determined by PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism). RESULTS No significant difference was detected in the distribution of the genotype frequencies of MTHFR C677T polymorphisms (χ (2) = 5.443, df = 2, p = 0.066) between patients and controls. But when we study the risk of these genotypes, CT genotype is significantly more frequent in controls compared to patients, it may be a protection from depression (OR = 0.655, CI 95 % = 0.432-0.995, p = 0.047, OR* = 0.638, CI 95 %* = 0.415-0.983, p* = 0.04, before and after adjustment). Women, TT Genotype can increase four times the risk to be depressive. Addictive behavior seems to be associated with CT genotype and there was no significant association between clinical and therapeutic characteristics and this polymorphism. CONCLUSION This paper is the first study to prove that CT genotype of MTHFR C677T polymorphism may protect from depression and TT genotype seems to be associated with women's depression. Further studies are required with other polymorphisms and biochemical factors that must be investigated to clarify the implication of MTHFR C677T polymorphism in the pathophysiology of depression.
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Affiliation(s)
- Mohamed Amine Sayadi
- Laboratory of Biochemistry-Toxicology, Monastir University Hospital, Monastir, Tunisia ; Research Laboratory "Vulnerability to Psychotic disorders LR 05 ES 10", Department of Psychiatry, Monastir University Hospital, Monastir, Tunisia
| | - Ons Achour
- LR 12 SP 11, Biochemistry Department, Sahloul Sousse University Hospital, Sousse, Tunisia
| | - Asma Ezzaher
- Laboratory of Biochemistry-Toxicology, Monastir University Hospital, Monastir, Tunisia ; Research Laboratory "Vulnerability to Psychotic disorders LR 05 ES 10", Department of Psychiatry, Monastir University Hospital, Monastir, Tunisia
| | - Ilham Hellara
- Laboratory of Biochemistry-Toxicology, Monastir University Hospital, Monastir, Tunisia
| | - Asma Omezzine
- LR 12 SP 11, Biochemistry Department, Sahloul Sousse University Hospital, Sousse, Tunisia
| | - Wahiba Douki
- Laboratory of Biochemistry-Toxicology, Monastir University Hospital, Monastir, Tunisia
| | - Ali Bousslama
- LR 12 SP 11, Biochemistry Department, Sahloul Sousse University Hospital, Sousse, Tunisia
| | - Lotfi Gaha
- Research Laboratory "Vulnerability to Psychotic disorders LR 05 ES 10", Department of Psychiatry, Monastir University Hospital, Monastir, Tunisia
| | - Mohamed Fadhel Najjar
- Laboratory of Biochemistry-Toxicology, Monastir University Hospital, Monastir, Tunisia
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McHugh RK, Wigderson S, Greenfield SF. Epidemiology of substance use in reproductive-age women. Obstet Gynecol Clin North Am 2015; 41:177-89. [PMID: 24845483 DOI: 10.1016/j.ogc.2014.02.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A significant number of women of reproductive age in the United States use addictive substances. In 2012 more than 50% reported current use of alcohol, 20% used tobacco products, and approximately 13% used other drugs. Among women, use of these substances is associated with several significant medical, psychiatric, and social consequences, and the course of illness may progress more rapidly in women than in men. The prevalence of substance use and evidence of accelerated illness progression in women highlight the importance of universal substance use screening in women in primary care settings.
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Affiliation(s)
- R Kathryn McHugh
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Sara Wigderson
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Division of Women's Mental Health, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA
| | - Shelly F Greenfield
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Division of Women's Mental Health, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
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Misiak B, Frydecka D, Slezak R, Piotrowski P, Kiejna A. Elevated homocysteine level in first-episode schizophrenia patients--the relevance of family history of schizophrenia and lifetime diagnosis of cannabis abuse. Metab Brain Dis 2014; 29:661-70. [PMID: 24682777 PMCID: PMC4125810 DOI: 10.1007/s11011-014-9534-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Accepted: 03/18/2014] [Indexed: 01/24/2023]
Abstract
Accumulating evidence indicates that elevated homocysteine (Hcy) level occurs in first-episode schizophrenia (FES) patients. We included 56 FES patients and 53 healthy controls (HC). Plasma level of Hcy was significantly higher in FES patients than HC (p = 0.044). In addition, plasma levels of high-density lipoproteins (HDL) and folate were significantly lower in FES than in HC (p < 0.001). Positive family history of schizophrenia was associated with lower plasma HDL (p = 0.041) and vitamin B12 (p = 0.017), as well as higher level of Hcy (p = 0.017). Patients with FES, who abused cannabis, had higher levels of Hcy (p = 0.017), as well as lower levels of vitamin B12 (p = 0.017) and HDL (p = 0.041). Plasma Hcy negatively correlated with duration of untreated psychosis (r = -0.272, p = 0.042). There was a positive correlation between Hcy level and the severity of negative symptoms (r = 0.363, p = 0.006) and general psychopathology (r = 0.349, p = 0.008) assessed using Positive and Negative Syndrome Scale (PANSS). Vitamin B12 level was negatively associated with the severity of negative symptoms (r = -0.406, p = 0.002), while folate level negatively correlated with general psychopathology score (r = -0.365, p = 0.006) in PANSS. These results indicate that the severity of one-carbon metabolism alterations and HDL deficiency might be associated with family history of schizophrenia and cannabis abuse. Lower vitamin B12 and folate along with elevated Hcy may influence the severity of FES psychopathology.
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Affiliation(s)
- Blazej Misiak
- Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367, Wroclaw, Poland,
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de Castro A, Concheiro M, Shakleya DM, Huestis MA. Simultaneous quantification of methadone, cocaine, opiates, and metabolites in human placenta by liquid chromatography-mass spectrometry. J Anal Toxicol 2009; 33:243-52. [PMID: 19671243 PMCID: PMC3173945 DOI: 10.1093/jat/33.5.243] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A validated method for quantifying methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine, cocaine, benzoylecgonine, 6-acetylmorphine, morphine, and codeine in human placenta by liquid chromatography-ion trap mass spectrometry is described. Specimens (1 g) were homogenized and subjected to solid-phase extraction. Chromatographic separation was performed on a Synergi Polar RP column with a gradient of 0.1% formic acid and acetonitrile. The method was linear from 10 to 2000 ng/g for methadone and 2.5 to 500 ng/g for other analytes. Limits of detection were 0.25-2.5 ng/g, imprecisions < 9.1%CV, analytical recoveries 84.4-113.3%, extraction efficiencies > 46%, matrix effects -8.0-129.9%, and process efficiencies 24.2-201.0%. Method applicability was demonstrated by analysis of five placenta specimens from opioid-dependent women receiving methadone pharmacotherapy, with methadone doses ranging from 65 to 95 mg on the day of delivery. These are the first data on placenta concentrations of methadone and metabolites after controlled drug administration. Detection of other common drugs of abuse in placenta will also improve our knowledge of the usefulness of this matrix for detecting in utero drug exposure and studying disposition of drugs in the maternal-fetal dyad.
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Affiliation(s)
- Ana de Castro
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, Maryland 21224
- Forensic Toxicology Service, Institute of Legal Medicine, University of Santiago de Compostela, San Francisco s/n, Santiago de Compostela, 15782 Spain
| | - Marta Concheiro
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, Maryland 21224
| | - Diaa M. Shakleya
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, Maryland 21224
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, Maryland 21224
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