Meconium for drug testing
E. C. Maynard, L. P. Amoruso and W. Oh
Department of Pediatrics, University of Massachusetts Medical School, Worcester.
Samples of meconium from 28 neonates born to women suspected of drug abuse
were tested for drugs of abuse (ie, cocaine, morphine, codeine, and
marijuana). In each case, testing of urine from the mother, the newborn, or
both had been ordered by the attending physician because of suspected
maternal drug abuse. Seventeen (61%) of 28 meconium samples tested
positive; 28 (60%) of 47 urine samples were positive. Meconium test results
were concordant with the results of maternal or newborn urine testing in 24
(86%) of the 28 cases. In three cases, meconium was positive for cocaine
when newborn urine was negative; in one case, meconium was negative when
maternal urine was positive for cocaine. Compared with the combination of
maternal and newborn urine testing, meconium testing had an 82% positive
predictive value (14/17) and a 91% negative predictive value (10/11).
Collection of meconium is simpler and more reliable than collection of
urine, and testing of meconium was easily incorporated into routine
procedures at a busy commercial laboratory. Meconium is a useful sample for
drug detection in newborns.
