[Long-term psychiatric and behavioural consequences of prenatal exposure to psychoactive drugs]

A growing body of evidence supports the hypothesis that exposure to prenatal environmental risk factors increases the vulnerability for a broad range of psychiatric disorders. Although the association between exposure to obstetric complications and increased vulnerability for psychiatric disorders is well documented, few studies have explored the putative deleterious impact of psychoactive substances and xenoestrogens on subsequent liability for psychological disturbances. Cohort studies suggest that prenatal exposure to nicotine is a risk factor for conduct disorders, and some case-control studies have reported an association between prenatal nicotine exposure and attention deficit hyperactivity disorder. Studies on the long-term behavioural consequences of prenatal exposure to other licit and illicit psychoactive substances are hampered by methodological flaws limiting the interpretation of the findings. Regarding prenatal exposure to hormones, sparse findings suggest that exposure to xenoestrogens such as diethylstilbestrol may be a risk factor for psychiatric disorders, mediated by a deleterious impact of these substances on the foetal neurodevelopment. However, this hypothesis is largely speculative due to the low number of studies and their methodological limitations. Further studies are required to explore the long-term cognitive and behavioural consequences of prenatal exposure to psychoactive drugs and xenoestrogens.