Transfer of Methamphetamine (MA) into Breast Milk and Urine of Postpartum Women who Smoked MA Tablets during Pregnancy: Implications for Initiation of Breastfeeding
Transfer of Methamphetamine (MA) into Breast Milk and Urine of Postpartum Women who Smoked MA Tablets during Pregnancy: Implications for Initiation of Breastfeeding
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DOI：
10.1177/0890334415610080
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发表时间：
2016-05-01
影响因子：
2.6
通讯作者：
Kitsommart, Ratchada
中科院分区：
文献类型：
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作者：
Chomchai, Chulathida;Chomchai, Summon;Kitsommart, Ratchada
背景：在东南亚，孕妇使用甲基苯丙胺仍然是一个日益严重的问题。分娩后，母亲尿液MA检测阴性被认为反映了母乳中不存在MA，标志着母乳喂养开始。迄今为止，还没有数据描述围产期和产后MA转移到母乳中与女性在娱乐性吸烟后尿液排泄之间的关系。目的：本研究旨在确定母乳中烟熏MA的药代动力学及其与分娩前MA检测呈阳性的产后妇女尿液MA排泄的关系。方法：采用Acquity超高效液相色谱法（沃茨，米尔福德，马萨诸塞州，USA）和ACQUITY UPLC光电二极管阵列检测器（沃茨），对分娩前MA尿液药物筛查阳性的33名女性的定时尿液和母乳样本进行MA分析。结果：共分析了2例受试者的药代动力学数据。母乳中MA的半衰期值为11.3和40.3小时。绝对婴儿剂量为21.3和51.7 μ g/kg/天。甲基苯丙胺消失从母乳中约1天前，母亲尿MA成为negative.Conclusion：烟熏MA显示了类似的母乳药代动力学模式，以前报道的静脉MA。母乳喂养可以安全地开始在母亲的尿液MA屏幕已经变成阴性24小时。然而，同时进行母体药物使用治疗和筛查对于持续促进泌乳是必要的。
Background: Methamphetamine (MA) use by pregnant women remains a growing problem in South East Asia. After delivery, a negative maternal urine MA assay is assumed to reflect the absence of MA in breast milk and marks breastfeeding initiation. To date, no data exist that describe the relationship between the peripartum and postpartum transfer of MA into breast milk and its urinary excretion in women, following recreational use by smoking.Objective: This study aimed to determine the pharmacokinetic of smoked MA in breast milk and its relationship to urinary MA excretion in postpartum women who tested positive for MA before delivery.Methods: Timed urine and breast milk samples of 33 women who had positive urine drug screens for MA prior to delivery were analyzed for MA using Acquity Ultra Performance Liquid Chromatography (Waters, Milford, Massachusetts, USA) with the ACQUITY UPLC Photodiode Array Detector (Waters). Those participants with 4 or more timed breast milk samples were included for pharmacokinetic calculation using log-linear trapezoidal rule.Results: Pharmacokinetic data from 2 women were analyzed. The half-life values for MA in the breast milk were 11.3 and 40.3 hours. The absolute infant doses were 21.3 and 51.7 mu g/kg/day. Methamphetamine disappears from breast milk approximately 1 day before the maternal urine MA becomes negative.Conclusion: Smoked MA shows a similar breast milk pharmacokinetic pattern to previously reported intravenous MA. Breastfeeding can be safely initiated in mothers whose urine MA screen has turned negative for 24 hours. However, concurrent maternal substance use treatment and screening is necessary for continued promotion of lactation.