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Interpretation of Discordant Results in Maternal/Newborn Dyad Drug Screening

Received: 14 October 2022     Accepted: 4 November 2022     Published: 16 November 2022
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Abstract

Background: Identification of in utero illicit drug exposure has paramount importance in medical care and well-being of the newborn. Newborn drug screening has traditionally been performed on meconium; however, umbilical cord tissue has gained popularity as an alternative specimen. We present six cases of newborn drug testing results from different specimens to highlight the potential inconsistencies and challenges with interpretation. Methods: Six infants born to mothers with illicit drug use who underwent drug screening are reviewed. Analysis was performed on meconium, umbilical cord tissue, newborn and/or maternal urine samples. Available meconium and umbilical cord tissue were analyzed using immunoassay and confirmed by HPLC-MS/MS. Urine drug screening was performed on available specimens using Enzyme-Multiple Immunoassay Technique and confirmed using HPLC-MS/MS. IRB approval for the study was granted by the University of Louisville and University of Louisville Hospital. Results: In each case presented there was significant variation in toxicology results between maternal/infant urine, meconium, and umbilical cord tissue analysis. Conclusions: Discrepancies in drug screening results from different specimens have been observed in the six mother/infant dyads presented. The utility of each specimen is dependent on several considerations and may warrant the testing of different sample types. Review of potential causation for conflicting results can help clinicians to select the proper tests and assist with interpretation when results deviate between the types of specimens analyzed.

Published in American Journal of Pediatrics (Volume 8, Issue 4)
DOI 10.11648/j.ajp.20220804.19
Page(s) 244-251
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Newborn Drug Screening, Meconium, Umbilical Cord, Illicit Drug Use, Pregnancy

References
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Cite This Article
  • APA Style

    Norah Alghamdi, Tonya Robinson, Cierra Sharp, Saeed Jortani. (2022). Interpretation of Discordant Results in Maternal/Newborn Dyad Drug Screening. American Journal of Pediatrics, 8(4), 244-251. https://doi.org/10.11648/j.ajp.20220804.19

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    ACS Style

    Norah Alghamdi; Tonya Robinson; Cierra Sharp; Saeed Jortani. Interpretation of Discordant Results in Maternal/Newborn Dyad Drug Screening. Am. J. Pediatr. 2022, 8(4), 244-251. doi: 10.11648/j.ajp.20220804.19

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    AMA Style

    Norah Alghamdi, Tonya Robinson, Cierra Sharp, Saeed Jortani. Interpretation of Discordant Results in Maternal/Newborn Dyad Drug Screening. Am J Pediatr. 2022;8(4):244-251. doi: 10.11648/j.ajp.20220804.19

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  • @article{10.11648/j.ajp.20220804.19,
      author = {Norah Alghamdi and Tonya Robinson and Cierra Sharp and Saeed Jortani},
      title = {Interpretation of Discordant Results in Maternal/Newborn Dyad Drug Screening},
      journal = {American Journal of Pediatrics},
      volume = {8},
      number = {4},
      pages = {244-251},
      doi = {10.11648/j.ajp.20220804.19},
      url = {https://doi.org/10.11648/j.ajp.20220804.19},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20220804.19},
      abstract = {Background: Identification of in utero illicit drug exposure has paramount importance in medical care and well-being of the newborn. Newborn drug screening has traditionally been performed on meconium; however, umbilical cord tissue has gained popularity as an alternative specimen. We present six cases of newborn drug testing results from different specimens to highlight the potential inconsistencies and challenges with interpretation. Methods: Six infants born to mothers with illicit drug use who underwent drug screening are reviewed. Analysis was performed on meconium, umbilical cord tissue, newborn and/or maternal urine samples. Available meconium and umbilical cord tissue were analyzed using immunoassay and confirmed by HPLC-MS/MS. Urine drug screening was performed on available specimens using Enzyme-Multiple Immunoassay Technique and confirmed using HPLC-MS/MS. IRB approval for the study was granted by the University of Louisville and University of Louisville Hospital. Results: In each case presented there was significant variation in toxicology results between maternal/infant urine, meconium, and umbilical cord tissue analysis. Conclusions: Discrepancies in drug screening results from different specimens have been observed in the six mother/infant dyads presented. The utility of each specimen is dependent on several considerations and may warrant the testing of different sample types. Review of potential causation for conflicting results can help clinicians to select the proper tests and assist with interpretation when results deviate between the types of specimens analyzed.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Interpretation of Discordant Results in Maternal/Newborn Dyad Drug Screening
    AU  - Norah Alghamdi
    AU  - Tonya Robinson
    AU  - Cierra Sharp
    AU  - Saeed Jortani
    Y1  - 2022/11/16
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ajp.20220804.19
    DO  - 10.11648/j.ajp.20220804.19
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 244
    EP  - 251
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20220804.19
    AB  - Background: Identification of in utero illicit drug exposure has paramount importance in medical care and well-being of the newborn. Newborn drug screening has traditionally been performed on meconium; however, umbilical cord tissue has gained popularity as an alternative specimen. We present six cases of newborn drug testing results from different specimens to highlight the potential inconsistencies and challenges with interpretation. Methods: Six infants born to mothers with illicit drug use who underwent drug screening are reviewed. Analysis was performed on meconium, umbilical cord tissue, newborn and/or maternal urine samples. Available meconium and umbilical cord tissue were analyzed using immunoassay and confirmed by HPLC-MS/MS. Urine drug screening was performed on available specimens using Enzyme-Multiple Immunoassay Technique and confirmed using HPLC-MS/MS. IRB approval for the study was granted by the University of Louisville and University of Louisville Hospital. Results: In each case presented there was significant variation in toxicology results between maternal/infant urine, meconium, and umbilical cord tissue analysis. Conclusions: Discrepancies in drug screening results from different specimens have been observed in the six mother/infant dyads presented. The utility of each specimen is dependent on several considerations and may warrant the testing of different sample types. Review of potential causation for conflicting results can help clinicians to select the proper tests and assist with interpretation when results deviate between the types of specimens analyzed.
    VL  - 8
    IS  - 4
    ER  - 

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Author Information
  • Department of Pathology and Laboratory Medicine, University of Louisville Hospital, Louisville, The United States

  • Neonatal Medicine, Department of Pediatrics, University of Louisville, Louisville, The United States

  • Department of Pathology and Laboratory Medicine, University of Louisville Hospital, Louisville, The United States

  • Department of Pathology and Laboratory Medicine, University of Louisville Hospital, Louisville, The United States

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