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Drug Positivity Findings from a Universal Umbilical Cord Tissue Drug Analysis Program in Appalachia
Panitan Yossuck1,2, Danyel H Tacker1,2
1Department of Pediatrics, West Virginia University School of Medicine, Morgantown, WV.
The Journal of Applied Laboratory Medicine
|December 16, 2020
Summary
Umbilical cord tissue drug analysis (UCTDA) revealed a decrease in overall in utero drug exposure from 25% to 20% between 2013-2018. However, significant increases in exposure to specific drugs like oxycodone and amphetamines were observed.
Area of Science:
- Neonatal Abstinence Syndrome Research
- Public Health
- Toxicology
Background:
- West Virginia faces a severe opioid crisis impacting pregnant women and newborns.
- Universal umbilical cord tissue drug analysis (UCTDA) has been implemented since 2013 for screening.
- This study retrospectively analyzes UCTDA data to assess in utero drug exposure trends.
Purpose of the Study:
- To report the incidence of in utero drug exposure using retrospective UCTDA data.
- To analyze changes in drug positivity and the number of drugs detected in umbilical cord specimens over two distinct time periods.
- To provide data that can inform interventions for neonatal abstinence syndrome.
Main Methods:
- Retrospective analysis of two sequential UCTDA datasets (2013-2015 and 2016-2018).
- Analysis of UCTDA positivity by drug class and parent drug, excluding THC and certain opioids.
- Examination of the number of discrete drugs detected per specimen.
Main Results:
- Overall UCTDA positivity decreased from 25% to 20% between the two epochs.
- Significant increases in positivity were observed for hydrocodone (+407%), oxycodone (+240%), amphetamines (+506%), and cocaine (+417%).
- Fentanyl and morphine positivity decreased, while buprenorphine detection increased by 195%; most positive specimens contained one drug.
Conclusions:
- Universal UCTDA provides an unbiased method for assessing infant drug exposure.
- UCTDA data, combined with information on therapeutic drug use, can help analyze illicit drug use trends.
- This analysis can guide the development of interventions to mitigate neonatal abstinence syndrome.