MECONIUM ANALYSIS FOR IMPROVED IDENTIFICATION OF INFANTS EXPOSED TO COCAINE IN-UTERO

We screened anonymously oil mothers and infants born during a 31/2-mon th period to determine the prevalence of intrapartum cocaine use, test the maternal characteristics that are specific predictors of intraute rine cocaine exposure (IUCE), and compare the sensitivity of infant ur ine versus meconium samples for identification of IUCE. Of 1237 live b irths during the study period, a sample was obtained from 1201 mother- infant pairs. The overall prevalence of documented intrapartum cocaine exposure was 66 (5.5%) of 1201 pairs. Previously developed drug scree ning guidelines had a sensitivity of 89% for detecting IUCE in infants . Direct comparisons of samples from the same mother-infant pair revea led that there were no cases in which cocaine was found in infant urin e but not in meconium; however, infant urine testing missed 25% of the infants who had positive findings in meconium.,We conclude that (1) m econium testing was more likely than urine testing to identify an infa nt with IUCE, detecting an additional 33%; (2) there was significant m aternal cocaine use (5.5%) in a teaching hospital with a mixed patient population; (3) maternal characteristics known to identify infants at risk of having IUCE were useful in our population; and (4) IUCE of ne onates admitted to the neonatal intensive care unit was more common th an that of infants admitted to the regular newborn nursery.