title: Neonatal withdrawal syndrome after chronic maternal consumption of 4-methylethcathinone.
abstract: Synthetic cathinones have been markedly present in the Spanish drug market in recent years. These substances can be easily obtained in "smart shops", smoke shops, gas stations and web sites where they can be bought and received anonymously avoiding normal law controls. For the first time we present a case of a neonatal withdrawal syndrome in a baby born to a woman who was a chronic consumer of 4-methylethcathinone. The newborn presented with increased jitteriness and irritability, highpitched cry, hypertonia in the limbs and brisk tendon reflexes. 4-Methylethcathinone was identified and quantified by liquid chromatography tandem mass spectrometry in the four subsequent 3cm segments of maternal hair (4.3, 4.0, 4.0 and 3.9ng/mg hair starting from most proximal segment) accounting for maternal consumption during the whole pregnancy and before and in neonatal meconium (0.7ng/g) confirming fetal exposure during intrauterine life. Methadone and its metabolite were also measured in maternal and neonatal matrices. Counseling pregnant women and women who may become pregnant on the consequences of fetal drug exposure to new designer drugs like 4-methylethcathinone is critical to preventing poor neonatal outcomes. This case report is informative to those studying designer drugs and those clinically involved with pregnant women abusing psychoactive substances.
authors.affiliation: Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanitá, Rome, Italy. Electronic address: simona.pichini@iss.it.
authors.forename: Simona
authors.initials: S
authors.lastname: Pichini
authors.affiliation: Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanitá, Rome, Italy.
authors.forename: Maria Concetta
authors.initials: MC
authors.lastname: Rotolo
authors.affiliation: Unitat de Recerca Infància i Entorn (URIE), Paediatric Service, Institut Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: García
authors.affiliation: CAS Baluard, Agència de Salut Pública de Barcelona Service, Managed by Associació Benestar i Desenvolupament, Barcelona, Spain.
authors.forename: Noelia
authors.initials: N
authors.lastname: Girona
authors.affiliation: CAS Baluard, Agència de Salut Pública de Barcelona Service, Managed by Associació Benestar i Desenvolupament, Barcelona, Spain.
authors.forename: Lorna
authors.initials: L
authors.lastname: Leal
authors.affiliation: Unitat de Recerca Infància i Entorn (URIE), Paediatric Service, Institut Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
authors.forename: Oscar
authors.initials: O
authors.lastname: García-Algar
authors.affiliation: Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanitá, Rome, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Pacifici
mesh_terms: D000662:Amphetamines / Q000009:adverse effects*; D015198:Designer Drugs / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange; D009357:Neonatal Abstinence Syndrome / Q000209:etiology*; D011247:Pregnancy; D011427:Propiophenones / Q000009:adverse effects*; D019966:Substance-Related Disorders / Q000150:complications*
chemical_list: D000662:Amphetamines; D015198:Designer Drugs; D011427:Propiophenones; C585202:4-methylethcathinone
keywords: 4-Methylethcathinone; Hair testing; Meconium; Neonatal withdrawal syndrome