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Maternal and Neonatal Risk Factors Associated with Positive Toxicology Results

Hannah Pee1, Karen Hussein1,2, Gina Del Savio3

  • 1Division of Newborn Medicine, Regional Neonatal Intensive Care Unit, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, New York.

American Journal of Perinatology
|February 10, 2025
PubMed

The incidence of substance use disorder (SUD) during pregnancy continues to increase; however, the identification of SUD is challenging. The significance of individual risk factors and their association with toxicology is contentious. To identify maternal and neonatal risk factors associated with positive toxicology results for nonprescribed substance use during pregnancy.This retrospective study included pregnant persons and their infants, who were screened for predetermined risk factors for SUD during pregnancy. The toxicology test results of pregnant persons' urine and infants' urine, meconium/umbilical cord were correlated with risk factors.Maternal risk factors (history of prepregnancy or current SUD, on medication for opioid use disorders, insufficient prenatal care, sexually transmitted and blood-borne infections) and neonatal risk factors (neonatal opioid withdrawal syndrome, intrauterine growth restriction) showed a correlation with toxicology results.Combining maternal and neonatal risk factors with toxicology testing may accurately identify SUD in pregnancy. · Minimal prenatal care can be associated with positive infant toxicology.. · Intrauterine growth restriction/small for gestational age can be associated with positive infant toxicology.. · Combined maternal and infant testing is more sensitive at detecting prenatal substance use..

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