Drug testing in biological samples vs. maternal surveys for the detection of substance use during whole pregnancy

Gónzalez-Colmenero, Eva; Concheiro-Guisán, Ana; Lorenzo-Martínez, Marta; Concheiro, Marta; Lendoiro, Elena; de-Castro-Ríos, Ana; Vázquez, Débora Cañizo; Martínez-Reglero, Cristina

doi:10.1080/10550887.2020.1831137

Cited by 11 publications

(15 citation statements)

References 24 publications

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“…These results are consistent with the data from the literature on the investigation of in utero drug exposure by using alternative matrices, such as hair and meconium, where COC is the first or second most detected drug 17,22,23,27 . On the other hand, the population of the present study shows, unlike other populations reported in the literature, a lack of cases positive for amphetamines and amphetamine‐like drugs 2,8,15,21,22 …”

Section: Resultssupporting

confidence: 92%

“…In addition, maternal hair testing, according to the length of the hair shaft, offers the possibility of evaluating the addiction behaviour not only during the three trimesters of pregnancy but also during the immediately preceding months. Finally, the significant amount of hair sample that could be collected allows for the analysis of a wide spectrum of xenobiotics (including drugs and biomarkers) and for performing segmental analyses 22,23 …”

Section: Introductionmentioning

confidence: 99%

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Hair testing applied to the assessment of in utero exposure to drugs: Critical analysis of 51 cases of the University Hospital of Verona

Bertaso

Gottardo

Murari

et al. 2023

Drug Testing and Analysis

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The work discusses the results of hair and urine testing performed in 51 cases of suspected in utero drug exposure handled at the University Hospital of Verona from 2016 to 2022. On the day of birth or the day after birth, urine from mother and newborn (UM and UN) and hair from mother (HM), newborn (HN) and father (HF), if possible, were collected. Urine underwent immunoassay and GC–MS analysis, whereas hair underwent LC–MS/MS and GC–MS/MS analysis. In 50 out of 51 cases, HM and/or HN were available. In 92% of them, hair testing resulted in a positive, often (>50% cases) for more than one class of substance. The most detected substances were cocaine, opiates, methadone and cannabinoids. Maternal segmental analysis showed a prevalent decreasing concentration trend during pregnancy in case of positivity for one class of substances, whereas, as expected, a neatly prevalent increasing trend in the case of positivity for more than one class of substances. In nine cases, HF was also available, resulting in all being positive, usually for the same classes of substances identified in HM, thus questioning parental responsibility. In 33 cases, urine samples from the mother or newborn were also collected. Of them, 27 cases (82%) tested positive, showing peri‐partum drug consumption and then confirming the severity of the addiction. Hair testing showed to be a reliable diagnostic tool to investigate in utero drug exposure because of the possibility of obtaining a complete picture of maternal addictive behaviour and family background, thanks to segmental maternal hair analysis and father hair testing.

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Section: Resultssupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Hair testing applied to the assessment of in utero exposure to drugs: Critical analysis of 51 cases of the University Hospital of Verona

Bertaso

Gottardo

Murari

et al. 2023

Drug Testing and Analysis

View full text Add to dashboard Cite

show abstract

“…Different matrices made it possible to analyze the frequency of drug use throughout the pregnancy. Maternal hair was the matrix that identified the highest number of cases and possessed the largest detection window, followed by meconium [ 13 ]. Two other scientific studies, both published in 2017, analyzed the ability of meconium, urine, and umbilical cord blood to detect intrauterine opioid exposure [ 14 , 15 ]; these clear findings may assist clinicians in selecting the most appropriate test to confirm a suspicion of intrauterine opioid exposure.…”

Section: Biological Matricesmentioning

confidence: 99%

Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues

Albano

Spina²,

Pitingaro³

et al. 2023

Toxics

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Opioids have a rapid transplacental passage (i.e., less than 60 min); furthermore, symptoms characterize the maternal and fetal withdrawal syndrome. Opioid withdrawal significantly impacts the fetus, inducing worse outcomes and a risk of mortality. Moreover, neonatal abstinence syndrome (NAS) follows the delivery, lasts up to 10 weeks, and requires intensive management. Therefore, the prevention and adequate management of NAS are relevant public health issues. This review aims to summarize the most updated evidence in the literature regarding toxicological, clinical, and forensic issues of intrauterine exposure to opioids to provide a multidisciplinary, evidence-based approach for managing such issues. Further research is required to standardize testing and to better understand the distribution of opioid derivatives in each specimen type, as well as the clinically relevant cutoff concentrations in quantitative testing results. A multidisciplinary approach is required, with obstetricians, pediatricians, nurses, forensic doctors and toxicologists, social workers, addiction specialists, and politicians all working together to implement social welfare and social services for the baby when needed. The healthcare system should encourage multidisciplinary activity in this field and direct suspected maternal and neonatal opioid intoxication cases to local referral centers.

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“…5 Ascertainment of prenatal substance use based on self-report may underestimate actual substance use by as much as 10-fold, particularly in late pregnancy. 6,7 Significant barriers exist to maternal self-report, including stigma and criminalization of prenatal substance use, and fear of the subsequent removal of children from parental custody. 8,9 An alternative strategy to estimate late pregnancy substance exposure is biological sample testing.…”

mentioning

confidence: 99%

Umbilical Cord Collection and Drug Testing to Estimate Prenatal Substance Exposure in Utah

Smid¹,

Allshouse²,

McMillin³

et al. 2022

Obstetrics &Amp; Gynecology

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Drug testing in biological samples vs. maternal surveys for the detection of substance use during whole pregnancy

Cited by 11 publications

References 24 publications

Hair testing applied to the assessment of in utero exposure to drugs: Critical analysis of 51 cases of the University Hospital of Verona

Hair testing applied to the assessment of in utero exposure to drugs: Critical analysis of 51 cases of the University Hospital of Verona

Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues

Umbilical Cord Collection and Drug Testing to Estimate Prenatal Substance Exposure in Utah

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