DETECTION OF COCAINE EXPOSURE IN THE NEONATE - ANALYSES OF URINE, MECONIUM, AND AMNIOTIC-FLUID FROM MOTHERS AND INFANTS EXPOSED TO COCAINE

Cocaine and its metabolites were measured in urine, meconium,and amnio tic fluid specimens collected from 30 maternal-infant pairs with histo ries of prenatal cocaine use. Cocaine, benzoylecgonine, and ecgonine m ethyl ester were measured by isotope dilution gas chromatography-mass spectrometry. Mothers were interviewed at delivery regarding their coc aine use during pregnancy. There was qualitative agreement between the results of drug determinations in maternal urine, amniotic fluid, inf ant urine, and meconium. Although all of the mothers in this study adm itted to using cocaine during their pregnancy, cocaine or its metaboli tes were detected only in the 20 cases in which cocaine was used withi n 3 weeks before delivery. We conclude that when sufficiently sensitiv e analytic methods are used, maternal urine, infant urine, and meconiu m analyses yield equivalent results for detection of prenatal cocaine exposure. Importantly, neither meconium nor urinary drug measurements detected cocaine exposure when the last reported use was prior to 3 we eks before delivery.