Affiliation:
1. Department of Pathology, University of Utah Health , Salt Lake City, UT 84112, USA
2. ARUP Laboratories , 500 Chipeta Way, Salt Lake City, UT 84108, USA
3. ARUP Institute for Clinical and Experimental Pathology , 500 Chipeta Way, Salt Lake City, UT 84108, USA
Abstract
Abstract
Maternal drug use during pregnancy is a significant concern. Drug-exposed newborns are often born premature and may suffer from birth defects, neonatal abstinence syndrome and cognitive and developmental delays. Because of this, testing of neonatal specimens is carried out to assess fetal drug exposure during pregnancy. Umbilical cord tissue (UC) and meconium are commonly used specimens for this purpose. However, comprehensive studies comparing drug positivity rates and concentration in the two specimen types are lacking. To this end, 4,036 paired UC and meconium specimens originating from 13 states within the USA were identified, and retrospective analysis of drug positivity rates and drug concentration was performed for 31 analytes in 5 drug classes. Testing for 11-Nor-9-carboxy-tetrahydrocannabinol (THC-COOH) is a separate orderable for UC specimen at our laboratory, so a second data set was created for evaluation of this drug analyte with 2,112 paired UC and meconium specimens originating from 11 states. Testing of UC was performed by semi-quantitative liquid chromatography–tandem mass spectrometry (LC–MS-MS) assays, whereas, for meconium, an immunoassay-based screening preceded LC–MS-MS confirmation tests. Results generated for UC and meconium specimens were therefore compared for a total of 32 drug analytes from 6 drug classes. Drug concentrations for analytes were higher in meconium compared to UC, with the exception of phencyclidine. Despite this, the positivity rates for individual analytes were higher in UC, with the exception of THC-COOH and cocaine. Furthermore, analysis for multidrug positivity revealed that THC-COOH and opioids were the most common multidrug combination detected in both matrices. In conclusion, this study suggests that for most drug compounds, UC was more analytically sensitive to assess neonatal drug exposure by current methodologies. Additionally, by demonstrating that meconium has higher drug concentrations for most compounds, this study sets the stage for developing more sensitive assays in meconium.
Publisher
Oxford University Press (OUP)
Subject
Chemical Health and Safety,Health, Toxicology and Mutagenesis,Toxicology,Environmental Chemistry,Analytical Chemistry
Reference29 articles.
1. Drug exposure in newborns: effect of selected drugs prescribed to mothers during pregnancy and lactation;Rentsch;Therapeutic Drug Monitoring,2020
2. Prenatal substance abuse: short- and long-term effects on the exposed fetus;Behnke;Pediatrics,2013
3. Detection of drug-exposed newborns;Wabuyele;Therapeutic Drug Monitoring,2018
4. Developmental consequences of fetal exposure to drugs: what we know and what we still must learn;Ross;Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology,2015
5. How States Handle Drug Use During Pregnancy;Miranda,2015
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