Cocaine exposure during pregnancy: improving assessment with radioimmunoassay of maternal hair.
OBJECTIVE
To compare radioimmunoassay of postpartum maternal hair samples with a structured maternal interview for the detection of cocaine use during pregnancy.


METHODS
Radioimmunoassay of hair samples obtained postpartum was compared with self-report of cocaine use obtained by confidential, structured interviews of 405 postpartum women.


RESULTS
Cocaine or benzoylecgonine was detected in the hair samples of 129 of the 148 women (87%) who reported using cocaine at least once during pregnancy. Thirty-six of 257 women (14%) who reported that they had used no cocaine during pregnancy had positive hair tests. Positive hair assay with negative self-report was significantly more common among women who were unmarried (P = .001), African-American (P < .001), and multiparous (P = .035).


CONCLUSIONS
Hair analysis is a valuable complement to maternal self-report by interview. The methods used together provide a useful clinical and research technique yielding a comprehensive estimate of gestational cocaine exposure. Either method alone may result in misclassification of gestational cocaine exposure.
Grant
T
T
Department of Psychiatry and Behavioral Sciences, University of Washington Medical School, Seattle.
Brown
Z
Z
Callahan
C
C
Barr
H
H
Streissguth
A P
AP
D000328:Adult; D001741:Black or African American; D003042:Cocaine / Q000031:analogs & derivatives* / Q000032:analysis*; D005260:Female; D006197:Hair / Q000737:chemistry*; D006801:Humans; D007407:Interviews as Topic; D017533:Marital Status; D010298:Parity; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D011863:Radioimmunoassay; D012650:Self Disclosure; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders; D044465:White People
C005618:benzoylecgonine; D003042:Cocaine