The impact of an obstetric substance use screening and biologic testing protocol on neonatal drug testing

Area of Science:

• Perinatal health
• Neonatal outcomes
• Substance use screening

Background:

• Substance use during pregnancy poses risks to fetal development and long-term health.
• Standardized maternal screening protocols may mitigate testing disparities.
• Data on the impact of standardized drug screening on neonatal outcomes are limited.

Purpose of the Study:

• To evaluate the effect of a standardized obstetric substance use screening and testing protocol on neonatal outcomes.
• To assess disparities in neonatal drug testing related to maternal race, ethnicity, and insurance status.

Main Methods:

• Retrospective cohort study comparing pre- and post-intervention periods at a tertiary care center.
• Analysis of neonatal drug testing rates and associations with maternal demographics using generalized estimating equations.
• Inclusion of 3163 neonates in the pre-intervention group and 3389 in the post-intervention group.

Main Results:

• Neonatal drug testing decreased post-implementation of the standardized protocol (4.5% vs. 6.2%).
• A higher proportion of neonates lacked corresponding maternal tests post-intervention (70.8% vs. 32.3%).
• Black neonates showed higher odds of testing, which decreased after adjusting for insurance status.

Conclusions:

• A standardized maternal screening protocol was associated with reduced neonatal drug testing.
• Persistent disparities in neonatal testing necessitate further research.
• The study highlights the need for equitable substance use screening practices in perinatal care.