Drug screening of newborns by meconium analysis: a large-scale, prospective, epidemiologic study.
Drug screening of newborns by meconium analysis: a large-scale, prospective, epidemiologic study.
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通过胎便分析对新生儿进行药物筛查：一项大规模、前瞻性、流行病学研究。
DOI：
10.1542/peds.89.1.107
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发表时间：
1992
期刊：
影响因子：
8
通讯作者：
Maria Stevens
中科院分区：
文献类型：
--
作者：
E. Ostrea;M. Brady;Sybil Gause;Anna L. Raymundo;Maria Stevens
通过胎粪分析对新生儿进行了大规模的前瞻性药物筛查，以更准确地确定高危城市产科人群中药物使用的流行病学特征。从1988年11月到1989年9月，在围产期中心分娩的每一个其他新生儿都被前瞻性地招募，并通过放射免疫测定法分析他们的胎粪中三种常见滥用药物的代谢物-可卡因，吗啡（阿片类药物）和大麻素。在研究的3010名受试者中，44%对可卡因、吗啡或大麻素呈阳性; 31%对可卡因呈阳性，21%对吗啡呈阳性，12%对大麻素呈阳性。相比之下，只有335名（11%）母亲承认使用非法药物：用途：52%的新生儿尿液药物筛查阳性，88%的新生儿胎粪药物筛查阳性。孕妇吸毒流行率每月各不相同。在研究人群中，妊娠成瘾者的特征被注意到（P小于0.001）：服务患者，单身，多胎妊娠（大于3），很少或没有产前护理。与怀孕期间吸毒有关的主要问题主要见于接触可卡因和阿片剂的群体和母亲承认使用非法药物的群体。另一方面，大量在子宫内接触过毒品的新生儿，特别是母亲否认使用毒品的新生儿，在出生时看起来很正常，可能无法被认出来。通过高怀疑指数和胎粪药物分析，可以改善对这些高危新生儿的检测。
A large-scale, prospective drug screening of newborns by meconium analysis was done to determine more accurately the prevalence and epidemiologic characteristics of drug use in a high-risk urban, obstetric population. Every other neonate delivered in a perinatal center from November 1988 to September 1989 was prospectively enrolled and their meconium was analyzed by radioimmunoassay for the metabolites of three commonly abused drugs--cocaine, morphine (opiates), and cannabinoid. In 3010 subjects studied, 44% were positive for cocaine, morphine, or cannabinoid; 31% were positive for cocaine, 21% for morphine, and 12% for cannabinoid. In contrast, only 335 (11%) mothers admitted to illicit drug use: 52% of their newborns had a positive urine drug screen and 88% had a positive meconium drug screen. Prevalence of drug use among the pregnant women varied per month. A profile of the pregnant addict in the population studied was noted (P less than .001): service patient, single, multigravid (greater than 3), and little or no prenatal care. The major problems associated with drug use during pregnancy were principally noted in the group that was exposed to cocaine and opiates and in the group where the mothers admitted to the use of illicit drugs. On the other hand, a large number of neonates who have been exposed to drugs in utero, particularly those whose mothers denied the use of drugs, appear normal at birth and may not be recognized. Improved detection of these newborns at risk can be achieved with a high index of suspicion and meconium drug analysis.