Intensive surveillance for cocaine use in obstetric patients

To determine the value of intensive surveillance for cocaine use in pregnancy and also determine the prevalence of cocaine use in our institution.

Among 124 consecutive new obstetrical clinic patients, urine specimens were collected anonymously at the first prenatal visit, in each subsequent trimester of pregnancy, and on labor and delivery. Corresponding newborn urine and meconium were also collected for these patients. 324 urine specimens and 49 meconium specimens were obtained. A local private group also collected first prenatal visit urine from an additional 104 patients. Urine specimens were analyzed for cocaine metabolites by fluorescent polarization immunoassay with confirmation of positive results by gas chromatography/mass spectrophotometry.

One clinic patient had a positive cocaine screen. All other urine and meconium screens were negative.

Intensive surveillance did not increase the detection rate for cocaine abuse in our obstetric population. We also found that the prevalence of cocaine abuse among obstetrical patients at our institution is low (< 1%). These data reconfirm that resource allocation for drug treatment centers should be based on prevalence data specific to an area or institution.