Urine drug screening in mothers and newborns
J. D. Osterloh and B. L. Lee
Department of Laboratory Medicine, University of California, San Francisco.
A retrospective analysis of comprehensive urine drug screening was
performed during a 13-month period on specimens submitted from the Neonatal
Nursery and Obstetrics/Gynecology wards at San Francisco (Calif) General
Hospital (mothers, N = 601; newborns, N = 339). Of mothers and newborns,
respectively, 19.2% and 15.3% of all admissions during this period were
screened; 68.2% and 63.1% of urine samples submitted were positive for any
drug; 38.8% and 21.1% of screens were positive for more than one drug; and
45.8% and 41.6% were positive for cocaine. In mother-newborn pairs (N =
191) where urine samples were submitted within 4 days of each other, an 84%
concordance was shown for cocaine and 67% for methadone, but concordance
was much less for other drugs (less than 21%). These results indicate that
cocaine was the most common drug detectable in the peripartum period and
that both mothers and newborns should be tested to confirm the suspicion of
drug effect or withdrawal in the newborn.