Cocaine use during pregnancy: Sensitive detection by hair assay
Cocaine use during pregnancy: Sensitive detection by hair assay
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DOI：
10.2105/ajph.87.3.352
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发表时间：
1997-03-01
影响因子：
12.7
通讯作者：
Susser, M
中科院分区：
文献类型：
--
作者：
Kline, J;Ng, SKC;Susser, M
目标.本文比较了可卡因使用的两种测试，访谈和尿检的敏感性，与头发的放射免疫分析。在纽约市的一家医院，397名产科患者提供了访谈和头发样本; 377名患者获得了尿液样本。在这些病人中，241人正在接受产前护理（已登记），156人在没有产前护理的情况下分娩（未登记）。这241名登记的患者来自400名患者，包括所有报告使用可卡因的人（“曾经使用者”），所有报告使用可卡因的人都是父亲，但不是他们自己（“生活方式者”），以及一个既不是曾经使用者也不是生活方式者的女性样本。156名未登记的患者来自352名分娩时接受采访的妇女，排除报告使用。32%的人报告曾经使用可卡因，其中45%在采访前6个月内。尿检阳性率为20%，毛发检测阳性率为59%。毛发测试的估计灵敏度（92%）是尿液测试的3.1倍（95%置信区间[CI] = 2.5，3.8），是过去6个月报告的使用灵敏度的4倍（95%CI = 3.2，5.0）。结论。自我报告和尿检本身错过了大多数怀孕期间的可卡因使用者。头发测试大大提高了检测，从而可以加强产前可卡因使用对胎儿和儿童发育的影响的评估。
Objectives. This paper compares the sensitivity of two tests of cocaine use, interview and urine test, with that of a radioimmunoassay of hair.Methods. Interviews and hair samples were provided by 397 obstetric patients in one New York City hospital; urine samples were obtained in 377. Of these patients, 241 were receiving prenatal care (were registered) and 156 delivered without prenatal care (were unregistered). The 241 registered patients were derived from 400, comprising all reporting use of cocaine ever (''ever-users''), all reporting use by the father but not themselves (''lifestylers''), and a sample of women who were neither ever-users nor lifestylers. The 156 unregistered patients were derived from 352 women interviewed at delivery, unselected for reported use.Results. Thirty-two percent reported ever using cocaine, 45% of these within 6 months before interview. Urine tests were positive in 20%, hair tests in 59%. The estimated sensitivity of thr hair test (92%) was 3.1 times higher than that of the urine test (95% confidence interval [CI] = 2.5, 3.8) and 4 times higher than that of reported use in the past 6 months (95% CI = 3.2, 5.0).Conclusions. Self-report and urine tests alone miss most of cocaine users during pregnancy. Hair tests greatly improve detection and thus can enhance evaluations of the effects of prenatal cocaine use on fetal and child development.