Background: Prenatal exposure to illicit substances is responsible for several long-term negative health consequences. It is critical for healthcare professionals to know the extent and scope of prenatal substance exposure in their cases. Several studies exist with mixed results comparing the effectiveness of umbilical cord tissue (UCT) and meconium (MEC) as toxicology specimen types. The specific aim of this study is to compare the use of UCT and MEC regarding the time interval between the birth of the neonate, receipt of the specimen at the laboratory, and the hospital’s receipt of the final toxicology report. Method: The study queried de-identified results of 5358 consecutive UCT and 706 MEC from our laboratory. Results: The mean time from birth to receipt of the specimen at the laboratory for MEC and UCT was 4.5 days ± 2.9 days and 2.8 days ± 1.9 days, respectively. The mean time from birth to final report for MEC was 6.9 days ± 3.8 days, 5.7 days ± 3.3 days, and 8.4 days ± 3.8 days for all MEC specimens, negative MEC, and positive MEC, respectively. The mean time from birth to final report for UCT was 4.3 days ± 2.4 days, 3.5 days ± 2.2 days, and 5.4 days ± 2.2 days for all UCT, negative UCT and positive UCT, respectively. Discussion/Conclusion: Receipt of drug test results of the neonate prior to release from the hospital is critical. This study shows that UCT offers an advantage when results are needed quickly to make informed decisions about the health and well-being of newborns.
References
[1]
U.S. Department of Health and Human Services (DHHS) and Office of Disease Prevention and Health Promotion (2024) Healthy People 2030: Maternal, Infant, and Child Health. MICH-11.1 Increase Abstinence from Illicit Drugs among Pregnant Women. https://health.gov/healthypeople/objectives-and-data/browse-objectives/pregnancy-and-childbirth/increase-abstinence-illicit-drugs-among-pregnant-women-mich-11
[2]
Center for Behavioral Health Statistics and Quality (CBHSQ) (2017) 2020 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2020-nsduh-detailed-tables
[3]
Chiandetti, A., Hernandez, G., Mercadal-Hally, M., Alvarez, A., Andreu-Fernandez, V., Navarro-Tapia, E., et al. (2017) Prevalence of Prenatal Exposure to Substances of Abuse: Questionnaire versus Biomarkers. ReproductiveHealth, 14, Article No. 137. https://doi.org/10.1186/s12978-017-0385-3
[4]
Gray, T. and Huestis, M. (2007) Bioanalytical Procedures for Monitoring in Utero Drug Exposure. AnalyticalandBioanalyticalChemistry, 388, 1455-1465. https://doi.org/10.1007/s00216-007-1228-9
[5]
Ostrea, E.M., Parks, P.M. and Brady, M.J. (1988) Rapid Isolation and Detection of Drugs in Meconium of Infants of Drug-Dependent Mothers. ClinicalChemistry, 34, 2372-2373. https://doi.org/10.1093/clinchem/34.11.2372a
[6]
Ostrea, E.M., Brady, M.J., Parks, P.M., Asensio, D.C. and Naluz, A. (1989) Drug Screening of Meconium in Infants of Drug-Dependent Mothers: An Alternative to Urine Testing. TheJournalofPediatrics, 115, 474-477. https://doi.org/10.1016/s0022-3476(89)80860-1
[7]
Moore, C., Negrusz, A. and Lewis, D. (1998) Determination of Drugs of Abuse in Meconium. JournalofChromatographyB: BiomedicalSciencesandApplications, 713, 137-146. https://doi.org/10.1016/s0378-4347(97)00479-9
[8]
Le, N.L., Reiter, A., Tomlinson, K., Jones, J. and Moore, C. (2005) The Detection of Oxycodone in Meconium Specimens. JournalofAnalyticalToxicology, 29, 54-57. https://doi.org/10.1093/jat/29.1.54
[9]
Concheiro-Guisan, A. and Concheiro, M. (2014) Bioanalysis during Pregnancy: Recent Advances and Novel Sampling Strategies. Bioanalysis, 6, 3133-3153. https://doi.org/10.4155/bio.14.278
[10]
Concheiro, M. and Huestis, M.A. (2018) Drug Exposure during Pregnancy: Analytical Methods and Toxicological Findings. Bioanalysis, 10, 587-606. https://doi.org/10.4155/bio-2017-0260
[11]
Montgomery, D., Plate, C., Alder, S.C., Jones, M., Jones, J. and Christensen, R.D. (2005) Testing for Fetal Exposure to Illicit Drugs Using Umbilical Cord Tissue vs Meconium. JournalofPerinatology, 26, 11-14. https://doi.org/10.1038/sj.jp.7211416
[12]
Montgomery, D.P., Plate, C.A., Jones, M., Jones, J., Rios, R., Lambert, D.K., et al. (2008) Using Umbilical Cord Tissue to Detect Fetal Exposure to Illicit Drugs: A Multicentered Study in Utah and New Jersey. JournalofPerinatology, 28, 750-753. https://doi.org/10.1038/jp.2008.97
[13]
Marin, S.J., Christensen, R.D., Baer, V.L., Clark, C.J. and McMillin, G.A. (2011) Nicotine and Metabolites in Paired Umbilical Cord Tissue and Meconium Specimens. Therapeutic Drug Monitoring, 33, 80-85. https://doi.org/10.1097/ftd.0b013e3182055f14
[14]
Jones, J., Rios, R., Jones, M., Lewis, D. and Plate, C. (2009) Determination of Amphetamine and Methamphetamine in Umbilical Cord Using Liquid Chromatography-Tandem Mass Spectrometry. JournalofChromatographyB, 877, 3701-3706. https://doi.org/10.1016/j.jchromb.2009.09.021
[15]
Jones, J., Magri, R., Rios, R., Jones, M., Plate, C. and Lewis, D. (2011) The Detection of Caffeine and Cotinine in Umbilical Cord Tissue Using Liquid Chromatography-Tandem Mass Spectrometry. AnalyticalMethods, 3, 1310-1315. https://doi.org/10.1039/c0ay00625d
[16]
Jones, J.T., Jones, M., Jones, B., Sulaiman, K., Plate, C. and Lewis, D. (2015) Detection of Codeine, Morphine, 6-Monoacetylmorphine, and Meconin in Human Umbilical Cord Tissue: Method Validation and Evidence of in Utero Heroin Exposure. TherapeuticDrugMonitoring, 37, 45-52. https://doi.org/10.1097/ftd.0000000000000104
[17]
Moore, C.M., Brown, S., Negrusz, A., Tebbett, I., Meyer, W. and Jain, L. (1993) Determination of Cocaine and Its Major Metabolite, Benzoylecgonine, in Amniotic Fluid, Umbilical Cord Blood, Umbilical Cord Tissue, and Neonatal Urine: A Case Study. JournalofAnalyticalToxicology, 17, 62-62. https://doi.org/10.1093/jat/17.1.62
[18]
Labardee, R.M., Swartzwelder, J.R., Gebhardt, K.E., Pardi, J.A., Dawsey, A.C., Brent Dixon, R., et al. (2017) Method Performance and Clinical Workflow Outcomes Associated with Meconium and Umbilical Cord Toxicology Testing. ClinicalBiochemistry, 50, 1093-1097. https://doi.org/10.1016/j.clinbiochem.2017.09.016
[19]
Pandya, V., Wilker, C. and McMillin, G.A. (2022) Can Umbilical Cord and Meconium Results Be Directly Compared? Analytical Approach Matters. JournalofAnalyticalToxicology, 47, 96-105. https://doi.org/10.1093/jat/bkac037
[20]
Karr, A.J., Rayens, M.K. and Scott, L.K. (2022) Neonatal Abstinence Syndrome: Effectiveness of Targeted Umbilical Cord Drug Screening. JournalofPerinatology, 42, 1038-1043. https://doi.org/10.1038/s41372-022-01457-8
[21]
Palmer, K.L., Wood, K.E. and Krasowski, M.D. (2017) Evaluating a Switch from Meconium to Umbilical Cord Tissue for Newborn Drug Testing: A Retrospective Study at an Academic Medical Center. ClinicalBiochemistry, 50, 255-261. https://doi.org/10.1016/j.clinbiochem.2016.11.026
[22]
Yossuck, P. and Tacker, D.H. (2020) Drug Positivity Findings from a Universal Umbilical Cord Tissue Drug Analysis Program in Appalachia. TheJournalofAppliedLaboratoryMedicine, 6, 285-297. https://doi.org/10.1093/jalm/jfaa196