Cocaethylene in meconium specimens

Cocaethylene, a metabolite of cocaine and ethanol, exhibits cardiac and neurobehavioral effects. In order to determine the prevalence of this compound in meconium specimens, samples which gave a positive result for benzoylecgonine using fluorescence polarization immunoassay were analyzed by gas chromatography/mass spectrometry for cocaine, cocaethylene and benzoylecgonine. Deuterated cocaine, cocaethylene and benzoylecgonine were used as internal standards. Gas chromatography/mass spectrometry cutoff concentrations of 5.0 ng/g were utilized for all analytes. Of the 361 specimens which consecutively confirmed positive for cocaine or benzoylecgonine, 114 (31.6%) tested positive for cocaethylene. Further, cocaethylene accumulates in greater concentrations in meconium than urine, and is a useful analyte for identifying fetal alcohol exposure.