Methamphetamine detection in maternal and neonatal hair: implications for fetal safety.
BACKGROUND
Methamphetamine misuse is a serious health problem of epidemic proportions. Use of this drug, particularly during pregnancy, is difficult to ascertain. Sparse information is available on gestational exposure.


OBJECTIVE
To quantify methamphetamine accumulation in hair, identify the use of methamphetamine with other drugs of abuse and characterise correlations between concentrations of methamphetamine in maternal and neonatal hair.


METHODS
Motherisk laboratory at the Hospital for Sick Children routinely carries out analysis of methamphetamine in hair. Mothers and infants with positive results for methamphetamine in hair were identified. Drugs present in hair were analysed by ELISA and positive results were confirmed by gas chromatgraphy/mass spectrometry.


RESULTS
396 people positive for methamphetamine in their hair were identified from our database. Almost 85% of them were positive for at least one other drug of abuse, mostly cocaine. Eleven mother-baby pairs with hair positive for methamphetamine were identified. Methamphetamine levels in hair ranged between 0.13 and 51.97 ng/mg in the mothers and between 0 and 22.73 ng/mg in the neonates. Methamphetamine levels in mothers and neonates correlated significantly. One (9%) neonate was negative for methamphetamine even though the mother was positive.


CONCLUSIONS
To our knowledge, this is the first report on fetal exposure to methamphetamine during pregnancy, showing transplacental transfer of the drug, with accumulation in fetal hair. Hair measurement for methamphetamine in neonates is a useful screening method to detect intra-uterine exposure to the drug. The data also indicate that positive exposure to methamphetamine strongly suggests that the person is a polydrug user, which may have important implications for fetal safety.
Garcia-Bournissen
F
F
G Koren, The Motherisk Program, Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, University of Toronto, 555 University Avenue, 8th Floor, Black Wing, Toronto, Canada ON, USA. gidiup_2000@yahoo.com
Rokach
B
B
Karaskov
T
T
Koren
G
G
D000293:Adolescent; D000328:Adult; D000697:Central Nervous System Stimulants / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D003042:Cocaine / Q000032:analysis; D018765:Dopamine Uptake Inhibitors / Q000032:analysis; D005260:Female; D005333:Fetus / Q000187:drug effects*; D006197:Hair / Q000737:chemistry*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D008431:Maternal-Fetal Exchange / Q000502:physiology; D008694:Methamphetamine / Q000032:analysis*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000378:metabolism*; D019966:Substance-Related Disorders / Q000378:metabolism*
D000697:Central Nervous System Stimulants; D018765:Dopamine Uptake Inhibitors; D008694:Methamphetamine; D003042:Cocaine