Maternal and Neonatal Risk Factors Associated with Positive Toxicology Results

Abstract

Objective

The incidence of substance use disorder (SUD) during pregnancy continues to increase; however, the identification of SUD is challenging. The significance of individual risk factors and their association with toxicology is contentious. To identify maternal and neonatal risk factors associated with positive toxicology results for nonprescribed substance use during pregnancy.

Study Design

This retrospective study included pregnant persons and their infants, who were screened for predetermined risk factors for SUD during pregnancy. The toxicology test results of pregnant persons' urine and infants' urine, meconium/umbilical cord were correlated with risk factors.

Results

Maternal risk factors (history of prepregnancy or current SUD, on medication for opioid use disorders, insufficient prenatal care, sexually transmitted and blood-borne infections) and neonatal risk factors (neonatal opioid withdrawal syndrome, intrauterine growth restriction) showed a correlation with toxicology results.

Conclusion

Combining maternal and neonatal risk factors with toxicology testing may accurately identify SUD in pregnancy.

Key Points

• Minimal prenatal care can be associated with positive infant toxicology.

• Intrauterine growth restriction/small for gestational age can be associated with positive infant toxicology.

• Combined maternal and infant testing is more sensitive at detecting prenatal substance use.

Keywords

neonatal opioid withdrawal - drug use - pregnancy - neonatology - drug testing - prenatal drug testing - indications for drug testing - drug toxicology

Ethical Approval

This study was approved by the Institutional Review Board of Montefiore St. Luke's Cornwall Hospital Newburgh.

Authors' Contributions

Substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data—H.P., P.K., K.H., G.D. Drafting or revising the article critically for important intellectual content—H.P., P.K., K.H. Final approval of the version to be published—P.K.

Publikationsverlauf

Eingereicht: 15. Oktober 2024

Angenommen: 07. Februar 2025

Accepted Manuscript online:
10. Februar 2025

Artikel online veröffentlicht:
06. März 2025

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