Cocaine, nicotine, caffeine, and metabolite plasma concentrations in neonates.
The objective of this study was to measure the umbilical cord plasma levels of cocaine, nicotine, caffeine, and their metabolites. Thirty-six neonates at risk for prenatal cocaine exposure were prospectively enrolled. Umbilical cord plasma was analyzed by gas chromatography-mass spectroscopy for cocaine, cocaethylene, benzoylecgonine (BZE), nicotine, cotinine, and caffeine. Eighteen neonates were plasma positive for BZE, and 50% of these were also positive for cocaine. Cocaethylene was not found. The maximum plasma cocaine concentration was 88 ng/mL (mean, 39 ng/mL). The maximum plasma BZE concentration was 3880 ng/mL (mean, 844 ng/mL). Among BZE-positive babies, the mean plasma drug levels were as follows: nicotine, 1.8 ng/mL; cotinine, 94 ng/mL; and caffeine, 1205 ng/mL. Among the BZE-negative babies, the mean plasma drug levels were as follows: nicotine, 5.2 ng/mL; cotinine, 97 ng/mL; and caffeine, 1440 ng/mL. These cocaine levels raise the possibility of pharmacological effects of cocaine in the early neonatal period.
Dempsey
D A
DA
Department of Pediatrics, University of California, San Francisco 94143, USA.
Partridge
J C
JC
Jones
R T
RT
Rowbotham
M C
MC
D002110:Caffeine / Q000097:blood* / Q000652:urine; D003042:Cocaine / Q000031:analogs & derivatives / Q000097:blood* / Q000652:urine; D003367:Cotinine / Q000097:blood / Q000652:urine; D005312:Fetal Blood; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007231:Infant, Newborn; D009538:Nicotine / Q000097:blood* / Q000652:urine; D011446:Prospective Studies; D012495:San Francisco; D015813:Substance Abuse Detection / Q000379:methods
D002110:Caffeine; C005618:benzoylecgonine; D009538:Nicotine; C066444:cocaethylene; D003042:Cocaine; D003367:Cotinine