title: Correlation between self-reported cocaine use and urine toxicology in an inner-city prenatal population.
abstract: To determine the prevalence of recent cocaine use and the accuracy of self-reported use, the results of a urine assay for the major cocaine metabolite benzoylecgonine were compared with self-reported cocaine use in an inner-city prenatal population offered routine voluntary urine toxicology screening at the time of registration for prenatal care. During a 1-year period, 6866 women registered for prenatal care and 5200 (76%) consented to urine assays for cocaine metabolites. Of the women consenting to urine assays, 253 (5%) had positive assays for benzoylecgonine. Women with positive assays were significantly more likely than those with negative assays to be older (mean [SD] 27 [5] versus 23 [6] years), black, single, and unemployed. In addition, women with positive assays were significantly more likely to be multiparous, report > two sexual partners in the previous year, and acknowledge a history of a sexually transmitted disease (STD). Forty-seven percent of women with positive assays acknowledged cocaine use in the 6 months prior to sampling. Women with positive assays who denied cocaine use were significantly more likely than those who admitted use to be younger (mean [SD] 26 [5] versus 28 [4] years), to report > or = two sexual partners in the past year, and acknowledge a history of an STD. This analysis revealed a poor correlation between self-reported cocaine use and the results of urine assays for cocaine metabolites among women seeking prenatal care in an inner-city institution.
authors.affiliation: Department of Gynecology and Obstetrics, Emory University, Atlanta, Georgia 30303, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Lindsay
authors.forename: S
authors.initials: S
authors.lastname: Carmichael
authors.forename: H
authors.initials: H
authors.lastname: Peterson
authors.forename: J
authors.initials: J
authors.lastname: Risby
authors.forename: H
authors.initials: H
authors.lastname: Williams
authors.forename: L
authors.initials: L
authors.lastname: Klein
mesh_terms: D003042:Cocaine / Q000031:analogs & derivatives* / Q000652:urine; D005260:Female; D015438:Health Behavior; D006801:Humans; D011247:Pregnancy; D011295:Prenatal Care; D015995:Prevalence; D012650:Self Disclosure; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014505:Urban Population
chemical_list: C005618:benzoylecgonine; D003042:Cocaine