DETECTION OF INTRAUTERINE ILLICIT DRUG EXPOSURE BY NEWBORN DRUG-TESTING

Identification of intrauterine drug-exposed newborns with toxicologica l screening may have benefits including close follow-up of the infant by both medical and social services. Applying specific written guideli nes to select newborns for drug testing decreases bias and protects th e physicians and hospitals involved. All drugs reported as positive sh ould be confirmed by an appropriate second test. Urine and meconium te sting are the best current options for identifying drug-exposed neonat es. Urine testing sensitivity is low because of problems encountered i n urine collections and the high thresholds used in current urine assa ys. The disadvantage to meconium testing is the increased labor and ti me required to work with this material. Testing of newborn hair is unl ikely to be widely used until technically less demanding assays become available. Testing of amniotic fluid or gastric lavage is still in th e developmental stages. Adopting lower urine assay thresholds for newb orn samples would increase sensitivity and would be an appropriate mod ification of current methodologies.