Rates of substance and polysubstance use through universal maternal testing at the time of delivery

Objective To report substance and polysubstance use at the time of delivery. Study design A cross-sectional study was performed on mothers consented for universal drug testing (99%) during hospital admission at six delivery hospitals in Cincinnati, Ohio. Mass spectrometry urinalysis detected positiv...

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Bibliographic Details
Published inJournal of perinatology Vol. 42; no. 8; pp. 1026 - 1031
Main Authors Smith, Brittany L., Hall, Eric S., McAllister, Jennifer M., Marcotte, Michael P., Setchell, Kenneth D. R., Megaraj, Vandana, Jimenez, Kristine L., John Winhusen, T., Wexelblatt, Scott L.
Format Journal Article
LanguageEnglish
Published New York Nature Publishing Group US 01.08.2022
Nature Publishing Group
Subjects
692/308/174
692/499
Buprenorphine
Cocaine
Cotinine
Drug development
Drug testing
Drug withdrawal
Mass spectrometry
Mass spectroscopy
Medicine
Medicine & Public Health
Methadone
Methamphetamine
Narcotics
Neonatal abstinence syndrome
Neonates
Opioids
Overdose
Pediatric Surgery
Pediatrics
Software
Substance use
Urinalysis
Womens health
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ISSN0743-8346
1476-5543
1476-5543
DOI10.1038/s41372-022-01335-3

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Summary:Objective To report substance and polysubstance use at the time of delivery. Study design A cross-sectional study was performed on mothers consented for universal drug testing (99%) during hospital admission at six delivery hospitals in Cincinnati, Ohio. Mass spectrometry urinalysis detected positivity rates of 46 substances. Rates of positive drug tests for individual and common co-occurring substances measured were reported. Results 2531 maternal samples were tested (88%) and 33% contained cotinine, 11.3% THC, 7.2% opioids, 3.8% cocaine, and 1.9% methamphetamines. Polysubstance use prevalence was as high as 15%. Among mothers testing positive for methadone or buprenorphine, 93% also tested positive for cotinine and 39% tested positive for a third substance in addition to cotinine. Conclusions Substance use at delivery is more prevalent than previously reported. Many mothers testing positive for opioids also test positive for other substances, which may increase overdose risk and exacerbate neonatal opioid withdrawal syndrome (NOWS).
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Author Contribution
BLS and SLW drafted the initial manuscript, along with conducting the investigation, formal analysis, and data curation. Study conceptualization and design was performed by ESH, JMM, TJW, MPM, and KDRS. Methodology was performed by BLS, SLW, ESH, JMM, VM, KLJ, and KDRS. Supervision/oversight for the investigation was conducted by SLW and KDRS. Funding was acquired by SLW and resources were provided by SLW and JMM. All authors assisted in reviewing or editing the manuscript, have given final approval of the version to be published, and agree to be accountable for all aspects of the work.
ISSN:0743-8346
1476-5543
1476-5543
DOI:10.1038/s41372-022-01335-3