USE OF MEPHEDRONE IN PREGNANCY

Cathinone is a naturally occurring stimulant compound found in khat (Catha edulis), a plant commonly chewed in regions of East Africa and the Arabian Peninsula for its psychoactive/CNS stimulant effects. Numerous synthetic cathinones, including mephedrone, are used recreationally.  

The available data regarding cathinone exposure in pregnancy are limited and predominantly consist of studies investigating the outcomes of women who chewed khat leaves in pregnancy. The available evidence, although limited, does not suggest that exposure in the first trimester is associated with an increased risk of malformation. There is also no evidence to indicate that gestational exposure in the absence of maternal toxicity is associated with an increased risk of stillbirth. Likely confounded evidence is available which has linked khat leaf chewing with low infant birth weight, and conflicting results exist regarding the risk of preterm delivery following khat leaf exposure in pregnancy. No studies have investigated the risk of miscarriage.

As synthetic cathinones are generally more physiologically potent than natural cathinones consumed via khat leaves, it is possible that the available evidence relating to khat leaf use in pregnancy is insufficient to determine the fetal risks following synthetic cathinone exposure. To date, only a small number of pregnancies with exposure to synthetic cathinones have been described in the literature. The outcomes of these pregnancies have included stillbirth (following maternal intoxication), preterm delivery, low birth weight and neonatal withdrawal.

Cathinones are chemically similar to amfetamines, use of which during pregnancy is associated with an increased risk of preterm delivery, low infant birth weight or the infant being small for gestational age, and withdrawal symptoms in the neonate. Cathinones are vasoconstrictive and use in pregnancy may therefore carry similar risks to the fetus as those described for other vasoconstrictive agents such as cocaine. Further research is required to determine whether the risk of these adverse events is increased following maternal cathinone use.

The use of cathinones should be avoided during pregnancy. Owing to the lack of evidence regarding the fetal effects of in utero cathinone exposure and their similarity to amfetamines, careful monitoring of the pregnancy and infant, in particular enhanced surveillance of fetal growth and neonatal monitoring, may be required in cases of chronic maternal use. Discussion with UKTIS is recommended.