Taking ecstasy during pregnancy may increase the risk of congenital anomalies, according to Dr Patricia McElhatton (national teratology information centre, Newcastle-upon-Tyne) and colleagues. They report the results of a prospective follow-up study of 136 pregnancies in which there was exposure to ecstasy (Lancet 1999;354:1441). There were 78 liveborn infants, 11 pregnancies were miscarried and 48 women had terminations. Of the 78 infants born, 15.4 per cent (12 babies) had congenital anomalies, which was significantly higher than the expected incidence of 2 to 3 per cent. Cardiovascular and musculoskeletal anomalies were predominant. The authors conclude that while a link between ecstasy and congenital anomalies could not be confirmed by the study because the number of babies included was too small, the findings provide important inital data.