Effects of cocaine on the fetal‐placental endocrine axis in humans

Human and animal studies have reported that long term use of cocaine during pregnancy causes a host of pregnancy disorders. We postulated that cocaine affects fetal‐placental endocrine axis. The studies were conducted in vitro and in vivo. For in vitro study, placenta was obtained from subjects who were drug free throughout pregnancy (control). for in vivo study, fetal membranes were isolated from the placenta and amniotic fluid was aspirated at the time of birth in subjects who used cocaine on a regular basis throughout pregnancy. To detremine whether cocaine affects progesterone synthesis, cytrotrophoblasts cells were isolated from placenta immediately following delivery. To determine whether cocaine affects prostaglandins synthesis PGs (E2 and F2α) levels were measured in fetal membranes and in amniotic fluid. The results of this study show that 1) progesterone synthesis in cytotrophoblast cells decreased significantly (p<0.01) in the presence of cocaine and 2) PGE2 and PGF2 αlevels were significantly increased in fetal membranes and in the amniotic fluid in cocaine users (p<0.01). To determine whether cocaine effects cAMP levels in cytotrophoblast cells, cAMP levels were measured in cytotrophoblast cells in the presence of cocaine (in vitro study) and the data showed that cAMP levels decreased significantly (p>0.01). We conclude that cocaine initiates a cascade of biochemical chnges leading to decreased progesterone synthesis, an increased prostaglandins synthesis causing premature births and increased incidence of abruptio placenta in cocaine users in humans.