A sensitive, precise, and accurate liquid chromatography-mass spectrometry
(LC-MS-MS) method was developed to quantitate cocaine and cocaine metabolit
es, which were simultaneously extracted from suspected drug-positive meconi
um samples using solid-phase extraction. The ability to analyze cocaine and
multiple cocaine metabolites in meconium makes this method a powerful tool
for the study of cocaine exposure and metabolism in neonates, Of 22 sample
s, only 1 did not show the presence of cocaine or any metabolite of cocaine
. The identified metabolites varied both qualitatively and quantitatively b
etween samples. Ecgonine appears to hold the most promise as a diagnostic m
arker compound for neonatal cocaine exposure as this metabolite was present
in 21 of 21 of the positive samples tested, and at a relatively high media
n concentration. However, a core group of eight metabolites (present in at
least 20 of 21 positive samples) was identified that appears to possess the
greatest utility for determining cocaine exposure. Finally, the use of thi
s method for assessment of the magnitude of fetal cocaine exposure was demo
nstrated.