Drug screening of meconium in infants of drug-dependent mothers: An alternative to urine testing

Ostrea, Enrique M.; Brady, Mark; Parks, Patricia; Asensio, Dennis C.; Naluz, Alexander

doi:10.1016/s0022-3476(89)80860-1

Cited by 191 publications

(76 citation statements)

References 6 publications

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“…Assay of meconium, although not conclusive if the results are negative, is more likely to identify infants of drug-abusing mothers than is the testing of infant or maternal urine. 95,96 Other specimens that have been tested in research laboratories are maternal and neonatal hair. 97,98 Recently, testing of umbilical cord tissue by using drug class-specific immunoassays was shown to be in concordance with testing of paired meconium specimens at rates of 97%, 95%, 99%, and 91% for the detection of amphetamines, opiates, cocaine, and cannabinoids, respectively.…”

Section: Differential Diagnosismentioning

confidence: 99%

Neonatal Drug Withdrawal

Hudak¹,

Tan²,

Frattarelli³

et al. 2012

Pediatrics

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Maternal use of certain drugs during pregnancy can result in transient neonatal signs consistent with withdrawal or acute toxicity or cause sustained signs consistent with a lasting drug effect. In addition, hospitalized infants who are treated with opioids or benzodiazepines to provide analgesia or sedation may be at risk for manifesting signs of withdrawal. This statement updates information about the clinical presentation of infants exposed to intrauterine drugs and the therapeutic options for treatment of withdrawal and is expanded to include evidence-based approaches to the management of the hospitalized infant who requires weaning from analgesics or sedatives.

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Section: Differential Diagnosismentioning

confidence: 99%

Neonatal Drug Withdrawal

Hudak¹,

Tan²,

Frattarelli³

et al. 2012

Pediatrics

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608

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“…Cocaethylene, a metabolite present when cocaine and alcohol are used in combination, as well as other drugs of abuse including cannabinoids (THC), opiates, phencyclidine, amphetamines, and benzodiazepines [22,28] were also assessed. Meconium sampling was completed by collecting successive diapers from the same newborn and scraping the meconium from the diaper with a wooden spatula.…”

Section: Participantsmentioning

confidence: 99%

Dysmorphic and anthropometric outcomes in 6-year-old prenatally cocaine-exposed children

Minnes

Robin

Alt

et al. 2006

Neurotoxicology and Teratology

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Dysmorphologic and anthropometric assessments were performed on 154 6-year-old children prenatally exposed to cocaine (PCE) and 131 high-risk controls (NCE) of similar race and social class. Adjusted mean height z scores demonstrated a dose-response with metahydroxybenzoylecgonine above a threshold of 100 ng/g of meconium and greater cocaine exposure predicted lower weight for height z score. Higher average alcohol exposure throughout pregnancy and 3rd trimester predicted lower head circumference and weight z scores, respectively. Severity of marijuana use also predicted lower height for age but greater weight for height. There was not an increased rate of minor anomalies among the PCE cohort, nor was a consistent phenotype identified. After controlling for covariates, higher average prenatal cigarette exposure predicted higher incidence of cranial facial abnormalities. First trimester alcohol exposure predicted greater rates of ear abnormalities and third trimester marijuana exposure predicted greater rates of chest and head shape abnormalities. These finding indicate that prenatal cocaine exposure has a negative effect on specific growth outcomes including standardized height and weight for height, but not a systematic pattern of structural abnormalities.

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“…This is a consequence of the repository nature of meconium for xenobiotics which facilitates the measurement of a wide window of exposure. Meconium is formed early in gestation and most xenobiotics that the fetus is exposed to during gestation are deposited in meconium, through fetal swallowing and/or bile secretion up to the time of birth (30). Since meconium, unlike fetal urine, is not normally excreted in utero, xenobiotics deposited in meconium accumulate and increase in concentration which further enhances the likelihood of their detection.…”

Section: Discussionmentioning

confidence: 99%

A comparison of infant hair, cord blood and meconium analysis to detect fetal exposure to environmental pesticides

Ostrea¹,

Bielawski²,

Posecion³

et al. 2008

Environmental Research

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OBJECTIVE-The detection of fetal exposure to environmental pesticides is important because many of the pesticides are neurotoxicants and fetal exposure to these compounds can adversely affect prenatal and subsequent neurodevelopment. The aim of this study was to determine, by the comparative analysis of infant hair, cord blood and meconium, the most sensitive matrix to detect fetal exposure to pesticides. PATIENTS AND METHODS-Pregnantwomen were prospectively recruited from an agricultural site in the Philippines where a preliminary survey indicated a substantial use at home and in the farm of the following pesticides: propoxur, cyfluthrin, chlorpyrifos, cypermethrin, pretilachlor, bioallethrin, malathion, diazinon and transfluthrin. Infant hair, cord blood and meconium were obtained after birth and were analyzed by gas chromatography/mass spectrometry for the above compounds, including lindane and DDT (1,1,1-trichloro-2,2-bis, p-chlorophenylethane) and some of their known metabolites.RESULTS-A total of 638 infants were included in the study. The highest exposure rate to pesticides was detected in meconium (23.8% to propoxur, 1.9% to pretilachlor, 1.9% to cypermethrin, 0.8% to cyfluthrin, 0.6% to DDT and 0.3% to malathion and bioallethrin). Cord blood was only positive for propoxur (1.9%) whereas infant hair was only positive for chlorpyrifos (0.2%). The highest exposure was to household pesticide (propoxur). The frequency and concentration of pesticides were compared in the three matrices and there was a significantly higher frequency and concentration of propoxur, pretilachlor, DDT, cyfluthrin and cypermethrin in meconium compared to cord blood and infant hair. Pesticide metabolites were not found in any of the matrices analyzed, except in one meconium sample which was positive for DDE (4,4′ dichlorodiphenyldichloro ethylene), a DDT metabolite.CONCLUSIONS-There is significant exposure of the pregnant woman and her fetus to pesticides, particularly to the home pesticide, propoxur. Our study has demonstrated that among cord blood, meconium or infant hair, meconium is the most sensitive matrix to analyze for fetal exposure to pesticides. The accumulation of pesticides in meconium, the ease of meconium collection and the Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. large amount of meconium that could be collected are factors that contribute to the increased sensitivity of this matrix. NIH Public Access

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Drug screening of meconium in infants of drug-dependent mothers: An alternative to urine testing

Cited by 191 publications

References 6 publications

Neonatal Drug Withdrawal

Neonatal Drug Withdrawal

Dysmorphic and anthropometric outcomes in 6-year-old prenatally cocaine-exposed children

A comparison of infant hair, cord blood and meconium analysis to detect fetal exposure to environmental pesticides

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