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Clinical Chemistry 43: 235-242, 1997;
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(Clinical Chemistry. 1997;43:235-242.)
© 1997 American Association for Clinical Chemistry, Inc.

Articles

Detection of intrauterine illicit drug exposure by newborn drug testing

Tai C. Kwong1,a and Rita M. Ryan2

Departments of
1 Pathology and Laboratory Medicine and
2 Pediatrics, School of Medicine and Dentistry, University of Rochester, Rochester, NY 14642.
a Author for correspondence. Fax 716-275-9333; e-mail tkwong{at}pathology.rochester.edu

Identification of intrauterine drug-exposed newborns with toxicological screening may have benefits including close follow-up of the infant by both medical and social services. Applying specific written guidelines to select newborns for drug testing decreases bias and protects the physicians and hospitals involved. All drugs reported as positive should be confirmed by an appropriate second test. Urine and meconium testing are the best current options for identifying drug-exposed neonates. Urine testing sensitivity is low because of problems encountered in urine collections and the high thresholds used in current urine assays. The disadvantage to meconium testing is the increased labor and time required to work with this material. Testing of newborn hair is unlikely to be widely used until technically less demanding assays become available. Testing of amniotic fluid or gastric lavage is still in the developmental stages. Adopting lower urine assay thresholds for newborn samples would increase sensitivity and would be an appropriate modification of current methodologies.


Key Words: indexing terms: meconium • urine testing • hair analysis • gas chromatography–mass spectrometry • drug screening • immunoassays




The following articles in journals at HighWire Press have cited this article:


Home page
 Clin. Chem.Home page
A. H.B. Wu, C. McKay, L. A. Broussard, R. S. Hoffman, T. C. Kwong, T. P. Moyer, E. M. Otten, S. L. Welch, and P. Wax
National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Recommendations for the Use of Laboratory Tests to Support Poisoned Patients Who Present to the Emergency Department
Clin. Chem., March 1, 2003; 49(3): 357 - 379.
[Abstract] [Full Text] [PDF]


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