title: A descriptive regional study of drug and alcohol use in pregnant women using results from urine drug testing by liquid chromatography-tandem mass spectrometry.
abstract: BACKGROUND
  Patterns of drug use during pregnancy may be changing. Identifying changes in pregnant women's drug use may help to target prevention and treatment.
  
  
  OBJECTIVE
  To determine the regional prevalence of drug and alcohol use among pregnant women in Southern California.
  
  
  METHODS
  This was a prospective, descriptive study conducted at a university health system's urban and suburban ambulatory obstetric offices. Included were pregnant women of all ages and trimesters. Excluded were non-pregnant women and women who had previously presented for an obstetric appointment during the data collection time period. Women provided a urine sample as part of routine care. Liquid chromatography-tandem mass spectrometry analysis of urine was performed for detection of a pre-selected sample of drugs and for alcohol. Descriptive statistics were performed.
  
  
  RESULTS
  A total of 295 urine samples were included. All trimesters were represented. A total of 14.2% of urine samples were positive for at least one of the tested drugs or alcohol. Alcohol was detected in 6% of the urine samples and was the most frequently identified substance. Prescription opioid analgesics (3.7% detection rate) and marijuana (4% detection rate) were the other most frequently detected substances.
  
  
  CONCLUSIONS
  Compared with older reports, our detection rates of prescription opioid analgesics were increased while rates of urinary alcohol detection were relatively unchanged, and detection rates of marijuana were decreased. Provider awareness of these substance detection rates may facilitate the identification of patients using these substances during pregnancy and ultimately help promote potential prevention and treatment.
authors.affiliation: a Department of Emergency Medicine, University of California San Diego , San Diego , CA , USA.
authors.forename: Allyson
authors.initials: A
authors.lastname: Kreshak
authors.affiliation: a Department of Emergency Medicine, University of California San Diego , San Diego , CA , USA.
authors.forename: Janna
authors.initials: J
authors.lastname: Villano
authors.affiliation: a Department of Emergency Medicine, University of California San Diego , San Diego , CA , USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Clark
authors.affiliation: b Reproductive Medicine, University of California San Diego , San Diego , CA , USA.
authors.forename: Pamela
authors.initials: P
authors.lastname: Deak
authors.affiliation: a Department of Emergency Medicine, University of California San Diego , San Diego , CA , USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Clark
authors.affiliation: b Reproductive Medicine, University of California San Diego , San Diego , CA , USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Miller
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000652:urine*; D002140:California / Q000453:epidemiology; D002853:Chromatography, Liquid; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000652:urine*; D011446:Prospective Studies; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000652:urine*; D053719:Tandem Mass Spectrometry; D055815:Young Adult
keywords: Pregnancy; alcohol use; drug use; fetal outcomes; liquid chromatography-tandem mass spectrometry