title: Alternative matrices for cocaine, heroin, and methadone in utero drug exposure detection.
abstract: BACKGROUND
  Drug determination in biological matrices from the mother and the newborn is an objective measure of maternal and fetal drug exposure. The aim of this study was to compare maternal hair, meconium, umbilical cord, and placenta for detecting in utero drug exposure to cocaine, opiates, methadone, and amphetamines.
  
  
  METHODS
  Maternal hair, meconium, umbilical cord, and placenta were collected from 175 mother-newborn dyads. Maternal hair (segmented in trimesters) and meconium specimens were analyzed for cocaine, opiates, methadone, and amphetamines. If either maternal hair or meconium tested positive, umbilical cord and placenta were analyzed. Analyses were performed by liquid chromatography tandem mass spectrometry.
  
  
  RESULTS
  In hair, 24 participants tested positive; 21 for cocaine [cocaine 20-50,605, benzoylecgonine (BE) 17-46,668 pg/mg], 7 for methadone (76-26,845 pg/mg), 2 for opiates (morphine 298-2398 pg/mg, codeine 65-914 pg/mg, 6-acetylmorphine 1635-15,657 pg/mg), and 1 for amphetamines (amphetamine 1990 pg/mg, 3,4-methylenedioxyamphetamine 30 pg/mg, 3,4-methylenedioxymethamphetamine 294 pg/mg). In meconium, 6 were positive; 5 for methadone [methadone 88-3752, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) 642-25,179 ng/g], 3 for cocaine (cocaine 7, BE 79, hydroxybenzoylecgonine 5-135, ecgonine-methyl ester 2-56 ng/g), and 2 for opiates (morphine 152-1025, morphine-3-glucuronide 22-23, codeine 4-34 ng/g). Placenta and umbilical cord were positive in 5 and 6 cases, respectively; 5 for methadone in placenta (methadone 7-543, EDDP 10-51 ng/g) and cord (methadone 3-183, EDDP 2-109 ng/g); 1 for cocaine in placenta (cocaine 7, BE 2 ng/g) and cord (BE 6 ng/g); and 1 for opiates in placenta (morphine 6, morphine-3-glucuronide 48 ng/g), and 2 in cord (morphine 2, morphine-3-glucuronide 15-38, morphine-6-glucuronide 5 ng/g). Meconium, placenta, and umbilical cord only tested positive if hair concentrations were greater than Society of Hair Testing cutoffs.
  
  
  CONCLUSIONS
  Maternal hair is the most sensitive specimen to detect drug consumption during pregnancy. Placenta and umbilical cord could be alternatives to meconium for detecting high in utero drug exposure.
authors.affiliation: Sección de Toxicología, Instituto de Ciencias Forenses, Universidad de Santiago de Compostela, Santiago de Compostela, Spain. marta.concheiro-guisan@nih.gov
authors.forename: Marta
authors.initials: M
authors.lastname: Concheiro
authors.forename: Eva
authors.initials: E
authors.lastname: González-Colmenero
authors.forename: Elena
authors.initials: E
authors.lastname: Lendoiro
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-Landeira
authors.forename: Manuel
authors.initials: M
authors.lastname: López-Rivadulla
mesh_terms: D002853:Chromatography, Liquid / Q000379:methods; D003042:Cocaine / Q000032:analysis* / Q000737:chemistry; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D006197:Hair / Q000737:chemistry; D003932:Heroin / Q000032:analysis* / Q000737:chemistry; D006801:Humans; D008431:Maternal-Fetal Exchange; D008470:Meconium / Q000737:chemistry; D008691:Methadone / Q000032:analysis* / Q000737:chemistry; D010920:Placenta / Q000737:chemistry; D011247:Pregnancy; D015813:Substance Abuse Detection / Q000379:methods*; D053719:Tandem Mass Spectrometry / Q000379:methods; D014470:Umbilical Cord / Q000737:chemistry; D014599:Uterus / Q000737:chemistry
chemical_list: D003932:Heroin; D003042:Cocaine; D008691:Methadone