Khat

(Date of issue: November 2016. Version: 1)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by Public Health England on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

What is it?

Khat is a plant that is commonly chewed in regions of East Africa and the Arabian Peninsula. It contains a stimulant substance called cathinone that causes changes in mood and behaviour.

Is it safe to use khat during pregnancy?

Khat use in pregnancy is not advised. When a pregnant woman uses khat it enters her bloodstream and crosses the placenta to the baby. The effects of khat on a developing baby in the womb are uncertain as very few pregnant women who use khat have been studied. There are, however, concerns that khat is harmful to a developing baby as it has been linked to poor growth of a baby in the womb. The substance in khat responsible for its stimulant properties (cathinone) is related to a class of drugs called amphetamines. Use of amphetamines in pregnancy has also been linked to low birth weight, as well as to preterm birth (see below). 

What if I have already used khat during pregnancy?

If you are pregnant and use khat you should speak to your doctor or midwife about this. They will be able to advise you on getting help and support to safely stop using khat.

Can using khat during pregnancy cause birth defects?

A baby’s body and most internal organs are formed during the first 12 weeks of pregnancy. It is mainly during this time that exposure to recreational drugs could potentially cause birth defects.

A single study of around 600 women who chewed khat in pregnancy showed that they were no more likely in general to have a baby with a birth defect than women who did not chew khat. However, many more pregnant women using khat need to be studied to confirm this finding. Possible links between khat use in pregnancy and specific types of birth defects have not been studied.

Can using khat in pregnancy cause miscarriage?

No studies have assessed whether chewing khat in pregnancy increases the likelihood of miscarriage. 

Can using khat in pregnancy cause stillbirth?

Stillbirth was no more common amongst 600 women who chewed khat in pregnancy than 600 who did not in the study mentioned above. However, no single study is perfect and other studies are needed to confirm this finding.

Can using khat in pregnancy cause low birth weight in the baby?

Three studies have suggested that babies born to women who chew khat might be at increased risk of having a baby with a low birth weight (<2,500 g). Amphetamines are a class of drugs related to khat. Use of amphetamines in pregnancy has also been linked to low infant birth weight. However, not all of the studies of pregnant women using khat accounted for other factors that can affect a baby’s birth weight (such as smoking, health problems in the mother, and poor living conditions). Further studies that take all of these factors into account are required before we can say how khat use in pregnancy might affect a baby’s weight.

Can using khat in pregnancy cause premature delivery (<37 weeks)?

A single study of around 600 women who chewed khat in pregnancy showed that they were no more likely to have a premature delivery than women who did not chew khat. However, use during pregnancy of amphetamines (drugs related to khat) has been shown to increase the risk of premature delivery. Many more pregnant women using khat therefore need to be studied before we can say whether use in pregnancy increases the risk of the having a premature baby.

Can using khat in pregnancy cause other health problems in the baby/child?

Withdrawal symptoms at birth
No studies have addressed whether exposure to khat in pregnancy can lead to withdrawal symptoms in the newborn baby.

Amphetamines are a class of drugs related to khat. Use of amphetamines in pregnancy has been linked to withdrawal symptoms in newborn babies (such as jitteriness, increased muscle tone, and high-pitched screaming). The risk of these problems is highest when amphetamines have been used throughout pregnancy or in the weeks before delivery. There is therefore a theoretical possibility that similar effects may occur in the baby following khat use in pregnancy. If you have used khat regularly during pregnancy it is important to tell your doctor or midwife. They may advise that your baby is born in a unit that can monitor and treat your baby for withdrawal symptoms if necessary.

Learning or behavioural problems in the child
A baby’s brain continues to develop right up until the end of pregnancy. It is therefore possible that exposure to certain substances at any stage of pregnancy could have a lasting effect on a child’s learning or behaviour.

No studies have addressed whether exposure to khat in the womb can affect learning and behaviour in the child. Because khat affects mood and behaviour there are theoretical concerns that it might have long-lasting effects on a baby’s developing brain that affect learning and concentration.

Will my baby need extra monitoring during pregnancy?

As part of their routine antenatal care most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects and to check the baby’s growth.

If you have used khat during pregnancy it is best for you and your baby that you tell your doctor or midwife as soon as possible. They will then be able to make sure that you and your baby receive extra monitoring or support if necessary. 

Are there any risks to my baby if the father uses khat?

No studies have specifically investigated whether khat used by the father can harm the baby through effects on the sperm, however most experts agree that this is very unlikely. More research on the effects of drug and medicine use in men around the time of conception is needed.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.  

General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

   

www.medicinesinpregnancy.org

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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