DETECTION OF PRENATAL DRUG EXPOSURE BY UR INE, MECONIUM, AND HAIR TESTING IN INFANTS FROM DRUG-DEPENDENT MOTHERS

Background.- Urinary detection of prenatal drug exposure in the neonat e may give false-negative results. We report our experience on meconiu m and hair testing, in addition to urine testing in order to improve d iagnosis of fetal drug exposure. Population and methods.- Thirty-one i nfants (aged 1-45 days) whose mothers were confirmed (n = 12) or suspe cted (n = 19) to be drug-addicted were included in the study. One or m ore specimens of urine, meconium or hair were collected in the 31 infa nts, two of the specimens in 17 and three in six. Drugs and their meta bolites were detected by immunoenzymologic techniques and positive res ults were confirmed by gas-exchange chromatography. All the mothers an d families were interviewed during admission and the information was c ompared to those provided by medical and social services; the results of laboratory analysis were not known by the investigators at this tim e of the study. Results.- The maternal drug addiction was confirmed af ter clinical investigation in 18 cases including the 12 cases detected by prenatal interview (group 1), and recused in 13 other cases (group 2). In group 1, nine infants of 12 had a positive urine test (seven o piate, one cocaine, one cannabis), 11 of 11 a positive meconium test ( nine opiate, one cocaine, one cannabis), ten of 19 a positive hair tes t (eight opiate, one cocaine, one cannabis); all infants in this group had at least one positive result. In group 2, all tests were negative except one urine test positive for opiate after cesarean delivery per formed under anesthesia including opiate analogsia. Conclusions.- Urin e, meconium and hair testing versus urine testing alone increase the s ensitivity of laboratory analysis for detection of prenatal drug expos ure.