Umbilical cord as an analytical matrix – A technical note

Price, Hayley R.; Chehroudi, Camron; Knight, Stuart J; Smith, Alexander D.; Lai, Dickson; Kim, Hugh; Wright, Tricia E.; Coughtrie, Michael W. H.; Collier, Abby C.

doi:10.1016/j.placenta.2019.12.001

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…As an option for monitoring in utero fetal drug exposure, cord tissue can be collected following birth. Collection of cord tissue can be conducted relatively quickly as it does not require an invasive procedure, utilizes an otherwise discarded specimen, and may reflect a relatively long window of drug detection ( Price et al, 2020 ).…”

Section: Fetal Drug Detection From Biological Fluid and Tissue Specimensmentioning

confidence: 99%

Drug exposure during pregnancy: Current understanding and approaches to measure maternal-fetal drug exposure

et al. 2023

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Prescription drug use is prevalent during pregnancy, yet there is limited knowledge about maternal-fetal safety and efficacy of this drug use because pregnant individuals have historically been excluded from clinical trials. Underrepresentation has resulted in a lack of data available to estimate or predict fetal drug exposure. Approaches to study fetal drug pharmacology are limited and must be evaluated for feasibility and accuracy. Anatomic and physiological changes throughout pregnancy fluctuate based on gestational age and can affect drug pharmacokinetics (PK) for both mother and fetus. Drug concentrations have been studied throughout different stages of gestation and at or following delivery in tissue and fluid biospecimens. Sampling amniotic fluid, umbilical cord blood, placental tissue, meconium, umbilical cord tissue, and neonatal hair present surrogate options to quantify and characterize fetal drug exposure. These sampling methods can be applied to all therapeutics including small molecule drugs, large molecule drugs, conjugated nanoparticles, and chemical exposures. Alternative approaches to determine PK have been explored, including physiologically based PK modeling, in vitro methods, and traditional animal models. These alternative approaches along with convenience sampling of tissue or fluid biospecimens can address challenges in studying maternal-fetal pharmacology. In this narrative review, we 1) present an overview of the current understanding of maternal-fetal drug exposure; 2) discuss biospecimen-guided sampling design and methods for measuring fetal drug concentrations throughout gestation; and 3) propose methods for advancing pharmacology research in the maternal-fetal population.

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Section: Fetal Drug Detection From Biological Fluid and Tissue Specimensmentioning

confidence: 99%

Drug exposure during pregnancy: Current understanding and approaches to measure maternal-fetal drug exposure

et al. 2023

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“…Furthermore, several studies have reported that cloned pigs exhibit umbilical cord (UC) malformations that reduce blood flow between maternal and foetal circulations; this restriction may be responsible for foetal malformations and low birth weights (Ao et al, 2017;Park et al, 2009). The UC is essential tissue for the growing foetus because it carries oxygen and nutrients from the placenta to the foetus during gestation (Price et al, 2020). The dynamic changes in metabolites between maternal-foetal exchange are influenced by the rates of metabolite production and degradation (Lin et al, 2012).…”

mentioning

confidence: 99%

Associations of cord metabolome and biochemical parameters with the neonatal deaths of cloned pigs

Zhao

et al. 2021

Reprod Domestic Animals

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Genetically engineered pigs generated through somatic cell nuclear transfer (SCNT) offer valuable applications in agriculture and biomedicine (Lee, Farrell, & Uh, 2020; Yang & Wu, 2018). However, the high stillbirth and malformation incidences and neonatal mortality rates of cloned pigs are the well-recognized problems (Schmidt, Winther, Secher, & Callesen, 2015). A growing body of evidence suggests that cloned pigs undergo abnormal development during their intrauterine life that contributes to the high loss of neonates and

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Concordance of Umbilical Cord Drug Screening in Multiple Births: Experience from a Reference Laboratory and Academic Medical Center

Nelson

Wood

McMillin

et al. 2021

Journal of Analytical Toxicology

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The objective of this study was to review the results of umbilical cord drug screening in twins and triplets (multiples) to compare drug(s) and/or drug metabolite(s) detected. Results that did not agree between multiples were considered mismatched and were investigated. A retrospective analysis was conducted using de-identified data from a national reference laboratory, and results were compared with data from an academic medical center, where detailed medical chart review was performed. Umbilical cord was analyzed for stimulants, sedatives, opioids, and other drugs and metabolites. For the reference laboratory dataset, 23.3% (n=844) of 3,616 umbilical cords from twins (n=3,550) or triplets (n=66) were positive for one or more drugs and/or metabolites. Of these, mismatched results were identified for thirty-seven sets of twins (2.1%) and no sets of triplets. The most frequent mismatches were found in opioids (n=24), with morphine (n=5) being the most mismatched of any single analyte in the panel. Mismatches for the marijuana metabolite 11-nor-9-carboxy-delta-9-tetrahydrocannabinol (9-COOH-THC) in the reference laboratory dataset occurred in six of 737 sets of twins (0.8%) and no triplets. For the academic medical center dataset, 21.9% (n=57) of 260 umbilical cords tested positive for one or more drugs and/or metabolite(s). Of these, 4 mismatches (3.2%) were identified, including 9-COOH-THC (n=2), phentermine (n=1), and oxycodone (n=1), all involving twins. All involved cases where the discrepant analyte was likely present in the negative twin but either slightly below reporting cutoff threshold, or failed analytical quality criteria. Mismatched results of umbilical cord drug screening occur in less than 4% of twins and most often occur when the analyte is slightly above the reporting cutoff in just one infant.

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Umbilical cord as an analytical matrix – A technical note

Cited by 3 publications

References 22 publications

Drug exposure during pregnancy: Current understanding and approaches to measure maternal-fetal drug exposure

Drug exposure during pregnancy: Current understanding and approaches to measure maternal-fetal drug exposure

Associations of cord metabolome and biochemical parameters with the neonatal deaths of cloned pigs

Concordance of Umbilical Cord Drug Screening in Multiple Births: Experience from a Reference Laboratory and Academic Medical Center

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