Since the last few years thousands of teenagers and young adults in the Netherlands participate in so called "houseparties", mostly during weekends. The majority (ab)uses ecstasy during those parties. As a result TIS Bilthoven is frequently consulted about ecstasy exposure in pregnancy.

The tablets sold as ecstasy may contain pure MDMA (methylene dioxy methamphetamine - ecstasy) or MDA (methylene dioxyamphetamine), MEA (methylene dioxy ethyl amphetamine), amphetamine and others.

To our knowledge there are no published human studies of exposures to ecstasy during pregnancy. TIS Bilthoven collected prospectively data on 49 such pregnancies.

Ecstasy was mosly used in weekends, weekly or incidentally. in 47 cases exposure occurred only during the first trimester of pregnancy, while 2 women were exposed in the second trimester only.

Twenty-one (43%) of the mothers took other drugs as well : cocaine (n=10), cannabis (n=10) and others. At least 24% used alcohol, some of them quite a lot (more than 3 units/day or binge drinking). At least 63% smoked cigarettes.

The mean age of the mothers was 26 (range 17-44). Only two of the pregnancies were known as planned. Before this pregnancy 7 mothers had already had an induced abortion once or more (induced abortion ratio: 52/100 pregnancies).

Of the 49 pregnancies, follow-up data are completed for 38 pregnancies. There were two spontaneous abortions and two elective terminations of pregnancy. Post mortem data on one of these induced abortions suggested an omphalocele (this mother's first pregnancy was spontaneously aborted). There were 36 liveborn normal babies including 6 premature babies (1 triple) and one with neonatal drug withdrawal effects. One term baby had a congenital heard defect and died a few hours after birth, this infant was exposed to ecstasy alone.

Conclusion: The sample presented here is too small to draw conclusions. As yet, spontaneous abortion and congenital malformations do not seem to occur more frequently. On the other hand, the lifestyle of ecstasy-users is potentially harmful for pregnancy and child.