Background: Identification of in utero illicit drug exposure has paramount importance in medical care and well-being of the newborn. Newborn drug screening has traditionally been performed on meconium; however, umbilical cord tissue has gained popularity as an alternative specimen. We present six cases of newborn drug testing results from different specimens to highlight the potential inconsistencies and challenges with interpretation. Methods: Six infants born to mothers with illicit drug use who underwent drug screening are reviewed. Analysis was performed on meconium, umbilical cord tissue, newborn and/or maternal urine samples. Available meconium and umbilical cord tissue were analyzed using immunoassay and confirmed by HPLC-MS/MS. Urine drug screening was performed on available specimens using Enzyme-Multiple Immunoassay Technique and confirmed using HPLC-MS/MS. IRB approval for the study was granted by the University of Louisville and University of Louisville Hospital. Results: In each case presented there was significant variation in toxicology results between maternal/infant urine, meconium, and umbilical cord tissue analysis. Conclusions: Discrepancies in drug screening results from different specimens have been observed in the six mother/infant dyads presented. The utility of each specimen is dependent on several considerations and may warrant the testing of different sample types. Review of potential causation for conflicting results can help clinicians to select the proper tests and assist with interpretation when results deviate between the types of specimens analyzed.
| Published in | American Journal of Pediatrics (Volume 8, Issue 4) |
| DOI | 10.11648/j.ajp.20220804.19 |
| Page(s) | 244-251 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2022. Published by Science Publishing Group |
Newborn Drug Screening, Meconium, Umbilical Cord, Illicit Drug Use, Pregnancy
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APA Style
Norah Alghamdi, Tonya Robinson, Cierra Sharp, Saeed Jortani. (2022). Interpretation of Discordant Results in Maternal/Newborn Dyad Drug Screening. American Journal of Pediatrics, 8(4), 244-251. https://doi.org/10.11648/j.ajp.20220804.19
ACS Style
Norah Alghamdi; Tonya Robinson; Cierra Sharp; Saeed Jortani. Interpretation of Discordant Results in Maternal/Newborn Dyad Drug Screening. Am. J. Pediatr. 2022, 8(4), 244-251. doi: 10.11648/j.ajp.20220804.19
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Download@article{10.11648/j.ajp.20220804.19,
author = {Norah Alghamdi and Tonya Robinson and Cierra Sharp and Saeed Jortani},
title = {Interpretation of Discordant Results in Maternal/Newborn Dyad Drug Screening},
journal = {American Journal of Pediatrics},
volume = {8},
number = {4},
pages = {244-251},
doi = {10.11648/j.ajp.20220804.19},
url = {https://doi.org/10.11648/j.ajp.20220804.19},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20220804.19},
abstract = {Background: Identification of in utero illicit drug exposure has paramount importance in medical care and well-being of the newborn. Newborn drug screening has traditionally been performed on meconium; however, umbilical cord tissue has gained popularity as an alternative specimen. We present six cases of newborn drug testing results from different specimens to highlight the potential inconsistencies and challenges with interpretation. Methods: Six infants born to mothers with illicit drug use who underwent drug screening are reviewed. Analysis was performed on meconium, umbilical cord tissue, newborn and/or maternal urine samples. Available meconium and umbilical cord tissue were analyzed using immunoassay and confirmed by HPLC-MS/MS. Urine drug screening was performed on available specimens using Enzyme-Multiple Immunoassay Technique and confirmed using HPLC-MS/MS. IRB approval for the study was granted by the University of Louisville and University of Louisville Hospital. Results: In each case presented there was significant variation in toxicology results between maternal/infant urine, meconium, and umbilical cord tissue analysis. Conclusions: Discrepancies in drug screening results from different specimens have been observed in the six mother/infant dyads presented. The utility of each specimen is dependent on several considerations and may warrant the testing of different sample types. Review of potential causation for conflicting results can help clinicians to select the proper tests and assist with interpretation when results deviate between the types of specimens analyzed.},
year = {2022}
}
TY - JOUR T1 - Interpretation of Discordant Results in Maternal/Newborn Dyad Drug Screening AU - Norah Alghamdi AU - Tonya Robinson AU - Cierra Sharp AU - Saeed Jortani Y1 - 2022/11/16 PY - 2022 N1 - https://doi.org/10.11648/j.ajp.20220804.19 DO - 10.11648/j.ajp.20220804.19 T2 - American Journal of Pediatrics JF - American Journal of Pediatrics JO - American Journal of Pediatrics SP - 244 EP - 251 PB - Science Publishing Group SN - 2472-0909 UR - https://doi.org/10.11648/j.ajp.20220804.19 AB - Background: Identification of in utero illicit drug exposure has paramount importance in medical care and well-being of the newborn. Newborn drug screening has traditionally been performed on meconium; however, umbilical cord tissue has gained popularity as an alternative specimen. We present six cases of newborn drug testing results from different specimens to highlight the potential inconsistencies and challenges with interpretation. Methods: Six infants born to mothers with illicit drug use who underwent drug screening are reviewed. Analysis was performed on meconium, umbilical cord tissue, newborn and/or maternal urine samples. Available meconium and umbilical cord tissue were analyzed using immunoassay and confirmed by HPLC-MS/MS. Urine drug screening was performed on available specimens using Enzyme-Multiple Immunoassay Technique and confirmed using HPLC-MS/MS. IRB approval for the study was granted by the University of Louisville and University of Louisville Hospital. Results: In each case presented there was significant variation in toxicology results between maternal/infant urine, meconium, and umbilical cord tissue analysis. Conclusions: Discrepancies in drug screening results from different specimens have been observed in the six mother/infant dyads presented. The utility of each specimen is dependent on several considerations and may warrant the testing of different sample types. Review of potential causation for conflicting results can help clinicians to select the proper tests and assist with interpretation when results deviate between the types of specimens analyzed. VL - 8 IS - 4 ER -
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