Meconium testing for cocaine metabolite: prevalence, perceptions, and pitfalls.
OBJECTIVE
We determined the prevalence of prenatal cocaine use in a racially mixed sample of urban and suburban mothers and correlated its use with maternal demographics and newborn measurements.


METHODS
Meconium from 621 consecutive newborns delivered at two university-affiliated urban hospitals were assayed for benzoylecgonine. Maternal and infant characteristics were linked anonymously with the results. Statistical analysis included t test, Fisher's exact test, Duncan's multiple range analysis, and analysis of covariance, with a value of p < 0.05 considered significant.


RESULTS
We found that 3.4% of meconium samples had benzoylecgonine levels exceeding 0.1 micrograms/ml. Its presence was statistically correlated with maternal and neonatal characteristics. A nurse's opinion of cocaine use was correct 22% of the time.


CONCLUSIONS
Prenatal cocaine use was statistically associated with multiparity, multigravidity, late-onset and clinic-based prenatal care, public assistance, nonwhite race, and low academic achievement. A nurse's opinion was a poor predictor of maternal cocaine use. Cocaine-exposed infants were significantly smaller, and this correlated best with nonwhite background.
Department of Pediatrics, Saint Francis Hospital and Medical Center, Hartford, Connecticut.
S S
SS
Rosengren
D B
DB
Longobucco
B A
BA
Bernstein
S
S
Fishman
E
E
Cooke
F
F
Boctor
S C
SC
Lewis
D001724:Birth Weight; D003042:Cocaine / Q000031:analogs & derivatives* / Q000032:analysis / Q000378:metabolism; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008470:Meconium / Q000737:chemistry*; D009726:Nurses; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011295:Prenatal Care / Q000706:statistics & numerical data; D015995:Prevalence; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism; D013383:Suburban Population; D014505:Urban Population
C005618:benzoylecgonine; D003042:Cocaine