title: Maternal hair analysis for the detection of illicit drugs, medicines, and alcohol exposure during pregnancy.
abstract: OBJECTIVE
  Drug of abuse consumption throughout pregnancy is a serious public health problem and an important economic cost to the health system. The aim of this work was to compare maternal interview and hair analysis to determine drug consumption throughout pregnancy and to study relations among maternal interview, hair results, and neonatal outcomes.
  
  
  METHODS
  Two hundred nine mothers agreed to participate. After delivery, they were interviewed and a hair sample collected. Hair samples were segmented in trimesters and analyzed for 35 drugs [opioids, cocaine, amphetamines, Δ-tetrahydrocannabinol (THC), ketamine, methadone, antidepressants, benzodiazepines, and hypnotics; limits of quantification 5-100 pg/mg] and for ethyl glucuronide (limit of quantification 10 pg/mg) by liquid chromatography-tandem mass spectrometry. Statistical analysis was performed with χ test and t test.
  
  
  RESULTS
  In the interview, 4.3% mothers declared using illicit drugs during pregnancy (cocaine 1.4%, THC 2.9%, and opiates 1%), 3.3% medicines (methadone 1.9%, benzodiazepines 1.9%, and antidepressants 0.5%), 21.5% tobacco, and 13.7% alcohol. Hair analysis showed 15.4% prevalence in illicit drugs (cocaine 12.4%, THC 3.8%, opiates 1%, and ketamine 1%), 22.5% in medicines (methadone 3.3%, benzodiazepines 11%, antidepressants 9.1%, zopiclone 1%, and fentanyl 1.4%), and 3.9% in alcohol. Neonatal abstinence syndrome was developed in 8.1% newborns, all of them from mothers with high methadone-positive hair results (>926.2 pg/mg). Statistically significant lower newborn weight and length were found in neonates from declared smokers compared with nonsmokers (P < 0.05).
  
  
  CONCLUSIONS
  Maternal hair analysis showed to be more sensitive than maternal interview to detect drug use during pregnancy, except for alcohol. In this preliminary study, no statistically significant differences were found between exposed and nonexposed newborns to drugs, except for tobacco consumption.
authors.affiliation: Sección de Toxicología, Instituto de Ciencias Forenses, Universidad de Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Lendoiro
authors.forename: Eva
authors.initials: E
authors.lastname: González-Colmenero
authors.forename: Ana
authors.initials: A
authors.lastname: Concheiro-Guisán
authors.forename: Ana
authors.initials: A
authors.lastname: de Castro
authors.forename: Angelines
authors.initials: A
authors.lastname: Cruz
authors.forename: Manuel
authors.initials: M
authors.lastname: López-Rivadulla
authors.forename: Marta
authors.initials: M
authors.lastname: Concheiro
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D002853:Chromatography, Liquid / Q000379:methods; D005260:Female; D006197:Hair / Q000737:chemistry*; D006801:Humans; D007231:Infant, Newborn; D007406:Interview, Psychological; D057230:Limit of Detection; D008875:Middle Aged; D009357:Neonatal Abstinence Syndrome / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011256:Pregnancy Outcome; D012907:Smoking / Q000009:adverse effects; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology; D053719:Tandem Mass Spectrometry / Q000379:methods; D055815:Young Adult