Timing of specimen collection is crucial in urine screening of drug dependent mothers and newborns

Halstead, Anne C.; Godolphin, William; Lockitch, Gillian; Segal, Sydney

doi:10.1016/s0009-9120(88)80113-9

Cited by 44 publications

(6 citation statements)

References 4 publications

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“…Methamphetamine use can be detected in hair, even after several years, if the section of the hair that grew during its use is still accessible 30. The possibility of measuring drugs in neonatal hair has made the detection of human fetal exposure to methamphetamine during gestation possible, a subject on which sparse information exists 31 – 36.…”

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confidence: 99%

Methamphetamine detection in maternal and neonatal hair: implications for fetal safety

García-Bournissen

Rokach

Karaskov

et al. 2007

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Background: Methamphetamine misuse is a serious health problem of epidemic proportions. Use of this drug, particularly during pregnancy, is difficult to ascertain. Sparse information is available on gestational exposure. Objectives: To quantify methamphetamine accumulation in hair, identify the use of methamphetamine with other drugs of abuse and characterise correlations between concentrations of methamphetamine in maternal and neonatal hair. Subjects and methods: Motherisk laboratory at the Hospital for Sick Children routinely carries out analysis of methamphetamine in hair. Mothers and infants with positive results for methamphetamine in hair were identified. Drugs present in hair were analysed by ELISA and positive results were confirmed by gas chromatgraphy/mass spectrometry. Results: 396 people positive for methamphetamine in their hair were identified from our database. Almost 85% of them were positive for at least one other drug of abuse, mostly cocaine. Eleven mother-baby pairs with hair positive for methamphetamine were identified. Methamphetamine levels in hair ranged between 0.13 and 51.97 ng/mg in the mothers and between 0 and 22.73 ng/mg in the neonates. Methamphetamine levels in mothers and neonates correlated significantly. One (9%) neonate was negative for methamphetamine even though the mother was positive. Conclusion: To our knowledge, this is the first report on fetal exposure to methamphetamine during pregnancy, showing transplacental transfer of the drug, with accumulation in fetal hair. Hair measurement for methamphetamine in neonates is a useful screening method to detect intra-uterine exposure to the drug. The data also indicate that positive exposure to methamphetamine strongly suggests that the person is a polydrug user, which may have important implications for fetal safety.

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confidence: 99%

Methamphetamine detection in maternal and neonatal hair: implications for fetal safety

García-Bournissen

Rokach

Karaskov

et al. 2007

Archives of Disease in Childhood - Fetal and Neonatal Edition

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“…Second, different biological specimens were used to confirm substance use in each cohort. Urine- and meconium-based tests have varying sensitivity, specificity, and windows of detection [48–50]. Third, only 22% of women in SMARTT had meconium samples analyzed for substances, and some women in the static SMARTT cohort had long recall periods.…”

Section: Discussionmentioning

confidence: 99%

Dramatic decline in substance use by HIV-infected pregnant women in the United States from 1990 to 2012

Rough

Tassiopoulos²,

Kacanek³

et al. 2015

Aids

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Objective We aimed to describe temporal changes in substance use among HIV-infected pregnant women in the US from 1990–2012. Design Data came from two prospective cohort studies (Women and Infants Transmission Study and Surveillance Monitoring for Antiretroviral Therapy Toxicities Study). Methods Women were classified as using a substance during pregnancy if they self-reported use or had a positive biological sample. To account for correlation between repeated pregnancies by the same woman, GEE models were used to test for temporal trends and evaluate predictors of substance use. Results Over the 23-year period, substance use among the 5,451 HIV-infected pregnant women sharply declined; 82% of women reported substance use during pregnancy in 1990, compared to 23% in 2012. Use of each substance decreased significantly (p<0.001 for each substance) in an approximately linear fashion, until reaching a plateau in 2006. Multivariable models showed substance use was inversely associated with receiving antiretroviral therapy. Among the subset of 824 women with multiple pregnancies under observation, women who used a substance in their previous pregnancy were at elevated risk of substance use during their next pregnancy (RR, 5.71; 95% CI, 4.63–7.05). Conclusions A substantial decrease in substance use during pregnancy was observed between 1990 and 2012 in two large US cohorts of HIV-infected women. Substance use prevalence in these cohorts became similar to that of pregnant women in the general US population by the mid-2000s, suggesting that the observed decrease may be due to an epidemiological transition of the HIV epidemic among women in the US.

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“…At times, sufficient neonatal plasma can be difficult to collect, and other matrices, for example, urine, is preferred 25. Although less invasive, the drawback of urine collection is that drugs clear rapidly from urine, and so the time required for successful collection is critical 26. False negatives are therefore possible, and so a negative urine screen cannot definitely rule out maternal prenatal substance abuse 5.…”

Section: Clinical Indicationsmentioning

confidence: 99%

How to use toxicology screening tests

Archer¹,

Wood

Dargan

2012

Arch Dis Child Educ Pract Ed

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Timing of specimen collection is crucial in urine screening of drug dependent mothers and newborns

Cited by 44 publications

References 4 publications

Methamphetamine detection in maternal and neonatal hair: implications for fetal safety

Methamphetamine detection in maternal and neonatal hair: implications for fetal safety

Dramatic decline in substance use by HIV-infected pregnant women in the United States from 1990 to 2012

How to use toxicology screening tests

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