title: Assessment of exposure to drugs of abuse during pregnancy by hair analysis in a Mediterranean island.
abstract: OBJECTIVE
  This study aims to estimate the prevalence of drug use by pregnant women living in Ibiza, using structured interviews and biomarkers in maternal hair. In addition, the potentially detrimental effects of maternal drug abuse on their newborns were investigated. Ibiza has a large international night-life resort associated with clubs, music and use of recreational drugs.
  
  
  METHODS
  Hair samples were collected prospectively from January to March 2010 from a cohort of consecutive mothers after giving birth in the Hospital Can Misses in Ibiza.
  
  
  METHODS
  Opiates, cocaine, cannabis, methadone, amphetamines, 3,4-methylenedioxymethamphetamine (MDMA) and their metabolites were detected in a 3-cm-long proximal segment of maternal hair corresponding to the last trimester of pregnancy by gas chromatography coupled to mass spectrometry (n = 107). Data on socio-demographic characteristics and on tobacco, alcohol, drugs of prescription and drugs of abuse consumption during pregnancy were collected using a structured questionnaire.
  
  
  RESULTS
  Hair analysis showed an overall 16% positivity for drugs of abuse in the third trimester of pregnancy, with a specific prevalence of cannabis, cocaine, MDMA and opiates use of 10.3, 6.4, 0.9 and 0%, respectively. In the questionnaires, only 1.9% of mothers declared using drugs of abuse during pregnancy. Gestational drug of abuse consumption was associated with active tobacco smoking, a higher number of smoked cigarettes and the mother being Spanish.
  
  
  CONCLUSIONS
  Illicit drug use is substantially under-reported among pregnant women living in Ibiza, particularly among Spanish nationals. Voluntary, routine objective biological toxicology screening should be considered as part of routine examinations in antenatal clinics on this Mediterranean island.
authors.affiliation: Unitat de Recerca Infància i Entorn, Institut Municipal d'Investigació Mèdica, Parc de Salut Mar, Barcelona, Spain. bfriguls@imim.es
authors.forename: Bibiana
authors.initials: B
authors.lastname: Friguls
authors.forename: Xavier
authors.initials: X
authors.lastname: Joya
authors.forename: Joan
authors.initials: J
authors.lastname: Garcia-Serra
authors.forename: Mario
authors.initials: M
authors.lastname: Gómez-Culebras
authors.forename: Simona
authors.initials: S
authors.lastname: Pichini
authors.forename: Susana
authors.initials: S
authors.lastname: Martinez
authors.forename: Oriol
authors.initials: O
authors.lastname: Vall
authors.forename: Oscar
authors.initials: O
authors.lastname: Garcia-Algar
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006197:Hair / Q000737:chemistry*; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis*; D008521:Mediterranean Islands / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology; D011296:Prenatal Diagnosis / Q000379:methods; D015995:Prevalence; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D015813:Substance Abuse Detection / Q000379:methods; D019966:Substance-Related Disorders / Q000453:epidemiology*
chemical_list: D015415:Biomarkers; D013287:Illicit Drugs