Newborn Drug Screening - Meconium Drug Testing

Newborn Drug Screening - Meconium Drug Testing

 

Exposure to maternal drug abuse during gestation may adversely affect neonatal development in addition to long-term childhood and adult outcomes.

Cocaine use associated with

  • Irritability and withdrawal at birth
  • Subarachnoid and intracerebral hemorrhage
  • Premature labor
  • Small neonatal head size
  • Reduced birth weight
  • Ruptured uterus
  • Fetal death
  • Childhood and adult behavioral disorders (Attention Deficit Hyperactivity Disorder - ADHD)

Amphetamines (particularly methamphetamine) use associated with

  • Effects that are similar to cocaine (both are central nervous system stimulants)
  • Complications during pregnancy
  • Increased rates of premature birth
  • Medical problems in early life

Cannabinoid (marijuana) use associated with

  • Negative effect on attentional behavior and on visual analysis/hypothesis testing
  • No effect on global IQ

Opiates, methadone, propoxyphene, barbiturates and benzodiazepines use associated with

  • Withdrawal symptoms
  • Irritability
  • Tremors
  • Hyperactivity
  • Seizures

Meconium (the dark, tarry material passed from the rectum in the first days after birth until milk or formula-based stool appears) is the specimen of choice for assessing in utero exposure of the neonate to maternal drug abuse.

  • Meconium is preferred over urine for testing.
  • Meconium documents multiple use over an extended period of time, covering the last 4-5 months of pregnancy
    • Urine testing can only indicate drug use over the last 1-10 days, depending on the drug
  • Meconium is easier to obtain than urine (combining all meconium voids can be helpful if sample size is small)