Increased cocaine and amphetamine-regulated transcript cord blood levels in the newborns exposed to crack cocaine in utero
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Cocaine and amphetamine-regulated transcript (CART) is an endogenous antioxidant present since the embryonic period. CART is activated by high levels of dopamine and might be of interested in understanding the changes in the REDOX system associated with crack/cocaine intake. The goal of this study was to determine whether exposure to crack in utero is associated with increased CART levels.
In this cross-sectional study with consecutive sampling, we compared the umbilical cord blood (UCB) CART levels (μg/mL) of newborns exposed to crack/cocaine in utero (EN, n = 57) to levels in non-exposed newborns (NEN, n = 99). In addition, we compared serum CART levels between EN and NEN mothers, in the immediate postpartum period. Potential confounders, such as perinatal data (e.g., weight, Apgar, etc.), psychopathology (DSM-IV), and use of drugs other than crack (ASSIST) were assessed.
According to general linear model analysis, the adjusted mean CART was significantly higher in EN (0.180, 95% CI 0.088–0.272) than in NEN (0.048, 95% CI 0.020–0.076; p < 0.002; d = 0.68). The difference in CART levels between EN and NEN mothers was not significant (p ≥ 0.05).
The increase in CART levels in EN UBC suggests a response to crack/cocaine-induced oxidative stress during gestational period, as a potential attempt of neuroprotection. In adult women in puerperium, however, this endogenous antioxidant recruitment does not seem to operate.
KeywordsCart Crack cocaine Pregnancy Umbilical cord blood Newborn Oxidative stress
We acknowledge all participants who took part in the present study and CAPES-PNPD (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Programa Nacional de Pós-Doutorado), edital 10/2009, and FIPE-HCPA (Fundo de Incentivo à Pesquisa-Hospital de Clínicas de Porto Alegre) for providing funding to this research.
Compliance with ethical standards
Conflicts of interest
Luis Augusto Rohde has been on the speakers’ bureau and/or acted as a consultant for Eli Lilly, Janssen-Cilag, Novartis, and Shire and receives royalties from Oxford Press and Artmed. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by Luis Augusto Rohde have received unrestricted educational and research support from the following pharmaceutical companies: Eli Lilly, Janssen-Cilag, Novartis, and Shire. Claudia M. Szobot has been on the speakers’ bureau of Novartis. Dr. Langleben served as a consultant for Alkermes Inc. No relevant conflicts to disclose. The other authors have no conflicts of interest to declare.
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