CORRELATION BETWEEN SELF-REPORTED COCAINE USE AND URINE TOXICOLOGY INAN INNER-CITY PRENATAL POPULATION

To determine the prevalence of recent cocaine use and the accuracy of self-reported use, the results of a urine assay for the major cocaine metabolite benzoylecgonine were compared with self-reported cocaine us e in an inner-city prenatal population offered routine voluntary urine toxicology screening at the time of registration for prenatal care. D uring a 1-year period, 6866 women registered For prenatal care and 520 0 (76%) consented to urine assays for cocaine metabolites. OF the wome n consenting to urine assays, 253 (5%) had positive assays for benzoyl ecgonine. Women with positive assays were significantly more likely th an those with negative assays to be older (mean [SD] 27 [5] versus 23 [6] years), black, single, and unemployed. In addition, women with pos itive assays were significantly more likely to be multiparous, report >two sexual partners in the previous year, and acknowledge a history o f a sexually transmitted disease (STD). Forty-seven percent of women w ith positive assays acknowledged cocaine use in the 6 months prior to sampling. Women with positive assays who denied cocaine use were signi ficantly more likely than those who admitted use to be younger (mean [ SD] 26 [5] versus 28 [4] years), to report greater than or equal to tw o sexual partners in the past year, and acknowledge a history of an ST D. This analysis revealed a poor correlation between self-reported coc aine use and the results of urine assays For cocaine metabolites among women seeking prenatal care in an inner-city institution.