Journal article
Umbilical Cord Drug Screening in Multiple Births: Experience from a Reference Laboratory and Academic Medical Center
Journal of analytical toxicology, Vol.46(6), pp.611-618
07/14/2022
DOI: 10.1093/jat/bkab077
PMID: 34165142
Abstract
The objective of this study was to review the results of umbilical cord drug screening in twins and triplets (multiples) to compare the detected drug(s) and/or drug metabolite(s). Results that did not agree between multiples were considered mismatched and were investigated. A retrospective analysis was conducted using de-identified data from a national reference laboratory, and results were compared with data from an academic medical center, where detailed medical chart review was performed. Umbilical cord was analyzed for stimulants, sedatives, opioids and other drugs and metabolites. For the reference laboratory dataset, 23.3% (n = 844) of 3,616 umbilical cords from twins (n = 3,550) or triplets (n = 66) were positive for one or more drugs and/or metabolites. Of these, mismatched results were identified for 37 sets of twins (2.1%) and no sets of triplets. The most frequent mismatches were found in opioids (n = 24), with morphine (n = 5) being the most mismatched of any single analyte in the panel. Mismatches for the marijuana metabolite 11-nor-9-carboxy-delta-9-tetrahydrocannabinol (9-COOH-THC) in the reference laboratory dataset occurred in 6 of 737 sets of twins (0.8%) and no triplets. For the academic medical center dataset, 21.9% (n = 57) of 260 umbilical cords tested positive for one or more drugs and/or metabolite(s). Of these, four mismatches (3.2%) were identified, including 9-COOH-THC (n = 2), phentermine (n = 1) and oxycodone (n = 1), all involving twins. All involved cases where the discrepant analyte was likely present in the negative twin but either slightly below the reporting cutoff threshold or failed analytical quality criteria. Mismatched results of umbilical cord drug screening occur in less than 4% of twins and most often occur when the analyte is slightly above the reporting cutoff in just one infant.
Details
- Title: Subtitle
- Umbilical Cord Drug Screening in Multiple Births: Experience from a Reference Laboratory and Academic Medical Center
- Creators
- Heather A. Nelson - University of UtahKelly E. Wood - University of IowaGwendolyn A. McMillin - University of UtahMatthew D. Krasowski - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Journal of analytical toxicology, Vol.46(6), pp.611-618
- Publisher
- Oxford Univ Press
- DOI
- 10.1093/jat/bkab077
- PMID
- 34165142
- ISSN
- 0146-4760
- eISSN
- 1945-2403
- Number of pages
- 8
- Language
- English
- Date published
- 07/14/2022
- Academic Unit
- Stead Family Department of Pediatrics; Pathology; Hospital Medicine
- Record Identifier
- 9984354006002771
Metrics
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