Immunoassay and GC-MS Procedures for the Analysis of Drugs of Abuse in Meconium

ElSohly, Mahmoud A.; Stanford, Donald F.; Murphy, Timothy P.; Lester, Barry M.; Wright, Linda L.; Smeriglio, Vincent L.; Verter, Joel; Bauer, Charles R.; Shankaran, Seetha; Bada, Henrietta S.; Walls, H. Chip

doi:10.1093/jat/23.6.436

Cited by 65 publications

(21 citation statements)

References 11 publications

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“…Meconium was collected for all study infants and sent to a central laboratory for analysis of metabolites of illicit drugs with the enzyme multiplied immunoassay technique, followed by gas chromatography/mass spectroscopy analysis of all positive samples. 6,17 Before discharge, maternal and infant charts were abstracted by the research nurse, using definitions from a manual of operations developed by the study investigators.…”

Section: Methodsmentioning

confidence: 99%

Association Between Patterns of Maternal Substance Use and Infant Birth Weight, Length, and Head Circumference

et al. 2004

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ABSTRACT. Objective. To determine the effects of patterns of drug use during term pregnancy on infant growth parameters at birth.Methods. Histories of cocaine, opiate, alcohol, tobacco, and marijuana use during the 3-month period before pregnancy and the 3 trimesters of pregnancy were recorded at the infants' 1-month visit. Patterns of use were categorized as consistently high, moderate, or low/ none or increasing/decreasing, and effects on growth parameters were analyzed in multivariate linear regression analyses, with adjustment for clinical site, maternal age, prepregnancy weight, multidrug use, and socioeconomic status.Results. A total of 241 cocaine-exposed women and 410 non-cocaine-exposed women participated in the study. In the cocaine-exposed group, 75% used alcohol, 90% used tobacco, and 53% used marijuana; in the noncocaine-exposed group, 57% used alcohol, 34% used tobacco, and 19% used marijuana. Birth weight, birth length, and head circumference were significantly greater among infants born to women who used no drugs, compared with women with any cocaine, opiate, alcohol, tobacco, or marijuana use, and were greater among infants born to cocaine nonusers, compared with cocaine users. With adjustment for confounders, birth weight was significantly affected by cocaine (deficit of 250 g with consistently low pattern) and tobacco (deficits of 232 g with consistently high pattern, 173 g with consistently moderate pattern, 153 g with decreasing pattern, and 103 g with consistently low pattern). Head size was affected by cocaine (deficit of 0.98 cm with consistently moderate pattern) and tobacco (deficits of 0.72 cm with consistently high pattern and 0.89 cm with consistently moderate pattern). Birth length was affected by tobacco use only (deficits of 0.82 cm with consistently high pattern and 0.98 cm with decreasing use).Conclusion. Patterns of tobacco use during pregnancy affect birth weight, length, and head circumference, whereas cocaine affects birth weight and head size, when adjustments are made for confounders, including multidrug use. Pediatrics 2004;114:e226 -e234. URL: http: //www.pediatrics.org/cgi/content/full/114/2/e226; prenatal, cocaine, alcohol, tobacco, marijuana, infant birth weight, length, head circumference.ABBREVIATIONS. MISU, Maternal Inventory of Substance Use. M aternal cocaine use during pregnancy has been associated with decreased growth parameters at birth for infants. [1][2][3][4][5] Women who use cocaine during pregnancy are often exposed to many drugs, including alcohol and tobacco, 1-6 both of which have been shown to have effects on birth weight in studies evaluating the use of these substances alone or in combination. [7][8][9][10][11][12][13] The timing and amount of fetal exposure to cocaine, tobacco, and alcohol during pregnancy also have been noted to influence birth weight. 2,10,11,14 Infants born to women who stopped smoking had higher birth weights than did those born to women who reduced smoking or who did not change behavior. 10,11 Infants born to women who drank ...

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Section: Methodsmentioning

confidence: 99%

Association Between Patterns of Maternal Substance Use and Infant Birth Weight, Length, and Head Circumference

et al. 2004

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“…Drug exposure was determined by self report during a brief interview at recruitment and meconium toxicology with presumptive positive screens confirmed with gas chromatography-mass spectrometry. The assay consisted of an enzyme multiplied immunoassay technique screen for cocaine, opiates, tetrahydrocannabinol, amphetamines, and phencyclidine followed by gas chromatography-mass spectroscopic confirmation of presumptive positive screens (see ElSohly et al 18 and Lester et al 19 for details). Initial screening for phencyclidine and amphetamine was stopped because of low prevalence.…”

Section: Methodsmentioning

confidence: 99%

Prenatal drug exposure and maternal and infant feeding behaviour

LaGasse

2003

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Objective: To evaluate feeding difficulties and maternal behaviour during a feeding session with 1 month old infants prenatally exposed to cocaine and/or opiates. Methods: The study is part of the maternal lifestyle study, which recruited 11 811 subjects at four urban hospitals, then followed 1388 from 1 to 36 months of age. Exposure to cocaine and opiates was determined by maternal interview and meconium assay. At the 1 month clinic visit, biological mothers were videotaped while bottle feeding their infants. This sample included 364 exposed to cocaine, 45 exposed to opiates, 31 exposed to both drugs, and 588 matched comparison infants. Mothers were mostly black, high school educated, and on public assistance. Videotapes were coded without knowledge of exposure status for frequency, duration and quality of infant sucking, arousal, feeding problems, and maternal feeding activity and interaction. Results: No cocaine effects were found on infant feeding measures, but cocaine-using mothers were less flexible (6.29 v 6.50), less engaged (5.77 v 6.22), and had shorter feeding sessions (638 v 683 seconds). Opiate exposed infants showed prolonged sucking bursts (29 v 20 seconds), fewer pauses (1.6 v 2.2 per minute), more feeding problems (0.55 v 0.38), and increased arousal (2.59 v 2.39). Their mothers showed increased activity (30 v 22), independent of their infants' feeding problems. Conclusions: Previous concerns about feeding behaviour in cocaine exposed infants may reflect the quality of the feeding interaction rather than infant feeding problems related to prenatal exposure. However, opiate exposed infants and their mothers both contributed to increased arousal and heightened feeding behaviour.F eeding is not only essential for growth, but is a primary context for interactions between infants and their mothers in early infancy.1 2 Early identification of dyads at risk for poor feeding offers an opportunity to intervene in the future health and wellbeing of the infant.1 3 4 Evaluation of neonatal feeding has been approached in three ways: clinical reports of dysfunctional sucking, objective (computer assisted) measurement of sucking patterns, and assessments of mother-infant interaction during feeding. Several studies have reported sucking or feeding problems when infants were prenatally exposed to cocaine or opiates, 1 5-12 although these observations are controversial. [13][14][15] Inconsistent findings may reflect a failure to account for polydrug exposure and sociodemographic factors, 5 7-11 small sample sizes with inadequate power to detect subtle effects or low generalisability, 1 5 6 9 10 12 15 and convenience samples that are not representative of the larger population of drug involved dyads.5 9 Further, no study used methods that could evaluate sucking, symptoms, and mother-infant interaction in the same sample. The purpose of this study was to test the hypotheses that infants exposed to cocaine and/or opiates have abnormal sucking patterns and increased feeding problems and that their mothers are less re...

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“…[15,[39][40][41] This raises the question of whether MAMP and AMP are the most appropriate biomarkers in meconium for the detection of in utero AMP exposure. Possibly, unidentified MAMP or AMP metabolites, other sympathomimetic amines, or endogenous meconium compounds cross-react with the immunoassay, triggering positive responses.…”

Section: Introductionmentioning

confidence: 99%

“…Possibly, unidentified MAMP or AMP metabolites, other sympathomimetic amines, or endogenous meconium compounds cross-react with the immunoassay, triggering positive responses. The presence of MAMP and AMP metabolites in meconium cannot always be detected with current confirmatory analytical methods that focus on parent compounds, AMP, MAMP, MDMA, MDA, MDEA and N-methyl-1-(3,4-methylenedioxyphenyl)-2-butanamine (MBDB) [15,22,23]; therefore MAMP-exposed neonates could be misidentified and denied interventional measures. Additionally, identification and quantification of other MAMP and AMP metabolites in meconium may provide valuable data regarding the maternal/fetal transfer of AMP-related drugs.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a liquid chromatography–atmospheric pressure chemical ionization-tandem mass spectrometry method for simultaneous analysis of 10 amphetamine-, methamphetamine- and 3,4-methylenedioxymethamphetamine-related (MDMA) analytes in human meconium

Kelly

Gray

Huestis

2008

Journal of Chromatography B

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A liquid chromatography-atmospheric pressure chemical ionization-tandem mass spectrometry (LC-APCI-MS/MS) method for quantification of ten amphetamine-related analytes in 1 g meconium is presented. Specimen preparation included homogenization and solid phase extraction. Two multiple reaction monitoring transitions were monitored per analyte. Ten and 1 µL injection volumes permitted quantification up to 10,000 ng/g, with sufficient sensitivity to quantify minor metabolites. Lower limits of quantification ranged from 1.25 to 40 ng/g. Precision was less than 14.2%, with accuracy between 79 -115%. Meconium from a methamphetamine-exposed neonate was analyzed. Metabolites p-hydroxymethamphetamine, norephedrine and 4-hydroxy-3-methoxymethamphetamine were identified in meconium for the first time.

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Immunoassay and GC-MS Procedures for the Analysis of Drugs of Abuse in Meconium

Cited by 65 publications

References 11 publications

Association Between Patterns of Maternal Substance Use and Infant Birth Weight, Length, and Head Circumference

Association Between Patterns of Maternal Substance Use and Infant Birth Weight, Length, and Head Circumference

Prenatal drug exposure and maternal and infant feeding behaviour

Development and validation of a liquid chromatography–atmospheric pressure chemical ionization-tandem mass spectrometry method for simultaneous analysis of 10 amphetamine-, methamphetamine- and 3,4-methylenedioxymethamphetamine-related (MDMA) analytes in human meconium

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