Bioanalysis During Pregnancy: Recent Advances and Novel Sampling Strategies

Guisán, Ana Concheiro; Concheiro, Marta

doi:10.4155/bio.14.278

Cited by 22 publications

(32 citation statements)

References 93 publications

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“…Maternal hair shows the longest window of detection and it has been used to monitor drug exposure during pregnancy . Maternal hair is considered the most sensitive specimens to detect drug consumption during this period . In the present study, also maternal hair was the most sensitive biological sample to detect drug use or abuse during the whole pregnancy.…”

Section: Discussionmentioning

confidence: 56%

“…Other biological specimens from the mother, such as blood, oral fluid, and urine, show a much shorter window of detection (blood and oral fluid hours, and urine days). Among the different specimens from the newborn, meconium, the first stool of an infant, is nowadays considered the ‘gold standard’ to reflect drug exposure during the third trimester . However, its expulsion may take up to 5 days after delivery, or it could be passed in utero , making this matrix unavailable for drug testing.…”

Section: Introductionmentioning

confidence: 99%

“…Placenta and umbilical cord offer the advantages of being available at birth and in adequate amount for analysis. However, data about drug and metabolite concentrations and window of detection is limited …”

Section: Introductionmentioning

confidence: 99%

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Bioanalysis for cocaine, opiates, methadone, and amphetamines exposure detection during pregnancy

Concheiro

Lendoiro

Castro

et al. 2016

Drug Testing and Analysis

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Drug exposure during pregnancy constitutes a major legal issue and a public health concern. Drug and metabolite determination in biological matrices from mother and newborn is an objective indication of prenatal drug exposure. However, limited data are available regarding the interpretation of these analytical results in terms of window of detection and degree of exposure. We collected paired maternal hair, meconium, placenta, and umbilical cord from 727 mother-newborn dyads. We analyzed these specimens by liquid chromatography-tandem mass spectrometry for the determination of cocaine, opioids, methadone, and amphetamines, and compared the analytical results from the four different matrices. The cases were divided in non-exposure, low, and frequent exposure, based on maternal hair concentrations and segmental analysis by trimesters. For cocaine, 62 cases tested positive in hair, 9 in meconium, 6 in placenta and 7 in umbilical cord. In the case of opioids, 14 maternal hair cases were positive, 11 meconium and umbilical cord and 9 placenta samples. For methadone, 11 cases were positive in hair, 9 in meconium and 6 in placenta and umbilical cord. For amphetamines, 18 cases were positive according to maternal hair, but all meconium, placenta, and umbilical cord tested negative. Maternal hair was the most sensitive specimen to detect drug exposure during pregnancy. Meconium, placenta, and umbilical cord tested positive if hair concentrations showed frequent drug use during the whole pregnancy, especially during the third trimester. Meconium, placenta, and umbilical cord also tested positive for morphine and metabolites, if this drug was administered during labour and delivery. Copyright © 2016 John Wiley & Sons, Ltd.

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Section: Discussionmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 99%

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Bioanalysis for cocaine, opiates, methadone, and amphetamines exposure detection during pregnancy

Concheiro

Lendoiro

Castro

et al. 2016

Drug Testing and Analysis

Self Cite

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“…Over the last years, meconium has proven to be a valuable matrix in the assessment of prenatal exposure to drugs of abuse and has gained a lot of interest due to the higher sensitivity, the easier sample collection and the larger detection window than traditional matrices, such as neonatal hair and urine 32 . To date, effort has been put in the development of Furthermore, the use of other non-invasive matrices in toxicology, such as nails, sweat and breast milk, has been enabled by the introduction of sensitive analytical techniques.…”

Section: Toxicologymentioning

confidence: 99%

Opening the toolbox of alternative sampling strategies in clinical routine: A key-role for (LC-)MS/MS

Velghe

Capiau

Stove

2016

TrAC Trends in Analytical Chemistry

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Alternative sampling strategies such as dried blood sampling, liquid microsampling and the sampling of oral fluid, hair, meconium, interstitial fluid, sweat, exhaled breath condensate and sputum offer interesting opportunities for many applications in clinical routine. Here, we provide an overview of different applications, with special attention to the pivotal role of LC-MS/MS in facilitating analysis of the collected matrices. Covered clinical fields include newborn screening, endocrinology, therapeutic drug monitoring, phenotyping, toxicology, proteomics and metabolomics. Furthermore, specific advantages, challenges and limitations of each alternative sampling strategy are discussed, along with recent advances and future trends that may contribute to routine implementation of these sampling strategies. Given the development of many recent potentially valuable clinical applications, the possibility of home sampling and the opportunity to obtain information that is hard to procure using traditional sampling, a well-balanced role for alternative sampling strategies can be envisaged in patient healthcare in the (near) future.

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“…51 Direct biomarkers include ethanol itself or the products of ethanol metabolism. Indirect markers are those that signal alcohol-induced pathology after chronic alcohol use.…”

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confidence: 99%

Objective Measures of Prenatal Alcohol Exposure: A Systematic Review

McQuire¹,

Paranjothy²,

Hurt³

et al. 2016

Pediatrics

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CONTEXT: Objective measurement of prenatal alcohol exposure (PAE) is essential for identifying children at risk for adverse outcomes, including fetal alcohol spectrum disorders. Biomarkers have been advocated for use in universal screening programs, but their validity has not been comprehensively evaluated. OBJECTIVE:To systematically review the validity of objective measures of PAE. DATA SOURCES:Thirteen electronic databases and supplementary sources were searched for studies published between January 1990 and October 2015.STUDY SELECTION: Eligible studies were those that evaluated the diagnostic accuracy of objective measures of PAE.DATA EXTRACTION: Three reviewers independently verified study inclusion, quality assessments, and extracted data. RESULTS:Twelve studies met inclusion criteria. Test performance varied widely across studies of maternal blood (4 studies; sensitivity 0%-100%, specificity 79%-100%), maternal hair (2 studies; sensitivity 19%-87%, specificity 56%-86%) maternal urine (2 studies; sensitivity 5%-15%, specificity 97%-100%), and biomarker test batteries (3 studies; sensitivity 22%-50%, specificity 56%-97%). Tests of the total concentration of 4 fatty acid ethyl esters (in meconium: 2 studies; in placenta: 1 study) demonstrated high sensitivity (82%-100%); however, specificity was variable (13%-98%).LIMITATIONS: Risk of bias was high due to self-report reference standards and selective outcome reporting.CONCLUSIONS: Current evidence is insufficient to support the use of objective measures of prenatal alcohol exposure in practice. Biomarkers in meconium and placenta tissue may be the most promising candidates for further large-scale population-based research. a Division of Population Medicine and b Specialist Unit for Review Evidence, Cardiff University, Cardiff, United KingdomMs McQuire developed the draft protocol and search strategy, data extraction sheet, and quality coding criteria; carried out study selection, data extraction, quality assessment, and evidence synthesis; and prepared the initial manuscript and subsequent revisions; Dr Paranjothy developed the initial concept for the study, contributed to development of the protocol, extracted data, verifi ed study inclusion decisions and quality assessments, and reviewed and revised the manuscript; Dr Hurt contributed to development of the protocol, extracted data, verifi ed study inclusion decisions and quality assessments, and reviewed and revised the manuscript; Ms Mann contributed to the design of the search strategy and reviewed and revised the manuscript; Dr Farewell provided statistical advice and reviewed and revised the manuscript; Dr Kemp contributed to development of the protocol and reviewed and revised the manuscript; and all authors approved the fi nal manuscript as submitted.This review has been registered at the PROSPERO international prospective register of systematic reviews (www. crd. york. ac. uk) (identifi er CRD42014015420).

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Bioanalysis During Pregnancy: Recent Advances and Novel Sampling Strategies

Cited by 22 publications

References 93 publications

Bioanalysis for cocaine, opiates, methadone, and amphetamines exposure detection during pregnancy

Bioanalysis for cocaine, opiates, methadone, and amphetamines exposure detection during pregnancy

Opening the toolbox of alternative sampling strategies in clinical routine: A key-role for (LC-)MS/MS

Objective Measures of Prenatal Alcohol Exposure: A Systematic Review

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