Role of Neonatal Biomarkers of Exposure to Psychoactive Substances to Identify Maternal Socio-Demographic Determinants

Abstract

Background: The accurate assessment of fetal exposure to psychoactive substances provides the basis for appropriate clinical care of neonates. The objective of this study was to identify maternal socio-demographic profiles and risk factors for prenatal exposure to drugs of abuse by measuring biomarkers in neonatal matrices. Methods: A prospective, observational cohort study was completed. Biomarkers of fetal exposure were measured in meconium samples. The mothers were interviewed using a questionnaire. Univariate and multivariate logistic regression analyses were performed. Results: A total of 372 mothers were included, 49 (13.2%) testing positive for psychoactive substances use: 24 (49.0%) for cannabis, 11 (22.5%) for ethyl glucuronide, six (12.2%) for cocaine, and in eight (16.3%) more than one psychoactive substance. Mothers who consumed any psychoactive substance (29.7 ± 6.6 years) or cannabis (27.0 ± 5.7 years) were younger than non-users (32.8 ± 6.2 years, p < 0.05). Cocaine (50.0% vs. 96.9%, p < 0.05) and polydrug users (37.5% vs. 96.9%, p < 0.05) showed a lower levels of pregnancy care. Previous abortions were associated with the use of two or more psychoactive substances (87.5% vs. 37.8%, p < 0.05). Single-mother families (14.3% vs. 2.5%, p < 0.05) and mothers with primary level education (75.5% vs. 55.1%, p < 0.05) presented a higher consumption of psychoactive substances. Independent risk factors that are associated with prenatal exposure include: maternal age < 24 years (odds ratio: 2.56; 95% CI: 1.12–5.87), lack of pregnancy care (odds ratio: 7.27; 95%CI: 2.51–21.02), single-mother families (odds ratio: 4.98; 95%CI: 1.37–8.13), and active tobacco smoking (odds ratio: 8.13; 95%CI: 4.03–16.43). Conclusions: These results will allow us to develop several risk-based drug screening approaches to improve the early detection of exposed neonates.

Prevalence of Licit and Illicit Drugs Use during Pregnancy in Mexican Women

“…Even if the effects of gestational consumption of psychoactive drugs on fetal development and pregnancy complications are widely known, the prevalence of licit and illicit psychoactive compounds consumption during pregnancy seems not to decrease in developed societies [ 1 , 2 , 5 , 6 , 7 ]. In this study, we demonstrated that also in a developing country, such as Mexico, the gestational consumption of licit and illicit psychoactive substances is not a negligible phenomenon.…”

“…Maternal use of prescription drugs during pregnancy is common and concerns medications to treat allergies and respiratory and gastrointestinal conditions, in addition to general analgesics [ 2 , 32 , 33 , 34 ]. In this study, 82.6% of pregnant women used a prescription drug, with paracetamol being the most used and generally considered safe during pregnancy [ 33 , 34 ].…”

“…The period of pregnancy is particularly delicate and requires special attention to protect the health of both the woman and her child. During pregnancy, the use of substances, whether legal or illicit, may cause health, social, and legal negative consequences [ 1 , 2 ].…”

“…Therefore, pharmacotoxicological laboratories, through the measurement of biomarkers of substances exposure in maternal and neonatal biological matrices, play an essential role in assessing the real maternal prevalence of illicit substance use and consequent prenatal exposure to them [ 2 , 18 , 19 , 20 , 21 , 22 , 23 ], allowing the generation of appropriate policies and interventions that are supportive, non-judgmental, and empathetic and help women to withdraw from drugs [ 17 , 24 ].…”

Neurodevelopmental Abnormalities in Children Associated with Maternal Use of Psychoactive Medication

“…Colombia is no stranger to this situation, and in the reports of the 2019 National Survey on the Use of Psychoactive Substances, it was found that 84% of those surveyed were alcohol consumers; 33.3% from tobacco; 1.8% from tranquilizing drugs; 8.3% marijuana; 2.1% from cocaine, and 1.6% from inhalable substances [2].…”