{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,24]],"date-time":"2024-08-24T22:33:32Z","timestamp":1724538812070},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,12]]},"abstract":"\n Background:<\/jats:title>\n Opioid and cocaine antenatal substance use can result in significant obstetric and pediatric health implications. Accurate detection of in utero\u2013exposed neonates can improve patient care and health outcomes. Therefore, the effectiveness of mother\u2013infant biological and diagnostic indicators collected at labor and delivery to provide accurate detection of in utero opiate and cocaine exposure was assessed.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A retrospective medical chart review included 335 mother\u2013infant dyads exposed to antenatal substances who were delivered between January 2009 and March 2014. Mother\u2013infant dyads were a subset of a larger retrospective cohort of 560 substance-using mothers, who had a valid meconium drug screen (MDS) and anesthesia before delivery. Alternative biological and diagnostic indicators of maternal urine drug screens (UDS), maternal substance use International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM)<\/jats:italic> codes, and neonatal exposure diagnostic ICD-9-CM<\/jats:italic> codes were compared against MDS. Data were analyzed using classification accuracy measures.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Compared with MDS, maternal UDS had the highest sensitivity [0.52, 95% confidence interval (CI), 0.39\u20130.65] and specificity (0.88, 95% CI, 0.79\u20130.97) to detect intrauterine opiate exposure. Maternal substance use diagnosis had the highest sensitivity (0.39, 95% CI, 0.16\u20130.61) and maternal UDS had the highest specificity (1.00, 95% CI, 0.99\u20131.00) to detect intrauterine cocaine exposure. Cocaine exposure had significantly higher accuracy scores across detection methods compared with opiate exposure.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Alternative indicators collected at delivery were ineffective at identifying in utero substance exposure, especially neonatal-exposed ICD-9-CM<\/jats:italic> codes. Low sensitivity scores indicate that many exposed neonates could be misdiagnosed or left untreated. Accurate antenatal exposure identification at delivery is an important form of tertiary assessment that warrants the development of improved screening methodology and standardization of hospital biological drug testing.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/ftd.0000000000000447","type":"journal-article","created":{"date-parts":[[2017,9,20]],"date-time":"2017-09-20T23:38:43Z","timestamp":1505950723000},"page":"640-647","source":"Crossref","is-referenced-by-count":4,"title":["Comparison of Biological Screening and Diagnostic Indicators to Detect In Utero Opiate and Cocaine Exposure Among Mother\u2013Infant Dyads"],"prefix":"10.1097","volume":"39","author":[{"given":"Meagan","family":"Stabler","sequence":"first","affiliation":[{"name":"The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth, Geisel School of Medicine, Lebanon, NH;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Giacobbi","sequence":"additional","affiliation":[{"name":"Department of Sport Sciences With Joint Appointment to Department of Epidemiology, West Virginia University, School of Public Health, Morgantown, WV;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilana","family":"Chertok","sequence":"additional","affiliation":[{"name":"College of Health Sciences and Professions, Ohio University, School of Nursing, Athens, OH;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leann","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Alabama at Birmingham, School of Public Health, Birmingham, AL; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lesley","family":"Cottrell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, West Virginia University, School of Medicine, Morgantown, WV."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panitan","family":"Yossuck","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, West Virginia University, School of Medicine, Morgantown, WV."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230814","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1542\/peds.2011-3212","article-title":"Neonatal drug withdrawal","volume":"129","author":"Hudak","year":"2012","journal-title":"Pediatrics"},{"key":"R2-20230814","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1542\/pir.32.1.5","article-title":"Infants of drug-dependent mothers","volume":"32","author":"Jansson","year":"2011","journal-title":"Pediatr Rev."},{"key":"R3-20230814","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1080\/14767050410001668635","article-title":"The impact of antenatal cocaine use on maternal characteristics and neonatal outcomes","volume":"15","author":"Ogunyemi","year":"2004","journal-title":"J Matern Fetal Neonatal Med."},{"key":"R4-20230814","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.ejogrb.2010.02.026","article-title":"Substance abuse during pregnancy: effect on pregnancy outcomes","volume":"150","author":"Pinto","year":"2010","journal-title":"Eur J Obstet Gynecol Reprod Biol."},{"key":"R5-20230814","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1001\/jama.2012.3951","article-title":"Neonatal abstinence syndrome and associated health care expenditures: United States, 2000-2009","volume":"307","author":"Patrick","year":"2012","journal-title":"JAMA"},{"key":"R6-20230814","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1007\/s10995-012-1046-3","article-title":"Prevalence of hospitalized live births affected by alcohol and drugs and parturient women diagnosed with substance abuse at liveborn delivery: United States, 1999-2008","volume":"17","author":"Pan","year":"2013","journal-title":"Matern Child Health J."},{"key":"R7-20230814","doi-asserted-by":"crossref","first-page":"56","DOI":"10.2307\/2648213","article-title":"Psychosocial factors and the timing of prenatal care among women in New Jersey\u2019s healthstart program","volume":"32","author":"Pagnini","year":"2000","journal-title":"Fam Plann Perspect."},{"key":"R9-20230814","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1176\/appi.ajp.158.2.213","article-title":"The detection and treatment of psychiatric disorders and substance use among pregnant women cared for in obstetrics","volume":"158","author":"Kelly","year":"2001","journal-title":"Am J Psychiatry."},{"key":"R10-20230814","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1007\/s00216-007-1228-9","article-title":"Bioanalytical procedures for monitoring in utero drug exposure","volume":"388","author":"Gray","year":"2007","journal-title":"Anal Bioanal Chem."},{"key":"R11-20230814","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1093\/clinchem\/43.1.235","article-title":"Detection of intrauterine illicit drug exposure by newborn drug testing. National Academy of Clinical Biochemistry","volume":"43","author":"Kwong","year":"1997","journal-title":"Clin Chem."},{"key":"R12-20230814","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/S1701-2163(16)34855-1","article-title":"Substance use in pregnancy","volume":"33","author":"Wong","year":"2011","journal-title":"J Obstet Gynaecol Can."},{"key":"R13-20230814","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1067\/mpd.2001.111429","article-title":"Estimates of illicit drug use during pregnancy by maternal interview, hair analysis, and meconium analysis","volume":"138","author":"Ostrea","year":"2001","journal-title":"J Pediatr."},{"key":"R14-20230814","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1097\/FTD.0b013e31828a6148","article-title":"Alternative matrices for cocaine, heroin, and methadone in utero drug exposure detection","volume":"35","author":"Concheiro","year":"2013","journal-title":"Ther Drug Monit."},{"key":"R16-20230814","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.cca.2005.10.028","article-title":"Drugs of abuse testing in meconium","volume":"366","author":"Gareri","year":"2006","journal-title":"Clin Chim Acta."},{"key":"R17-20230814","first-page":"571","article-title":"Meconium as a new biological material for detecting intrauterine exposure to toxic substances","volume":"76","author":"Lisowska-Myjak","year":"2005","journal-title":"Ginekol Pol."},{"key":"R18-20230814","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1097\/FTD.0b013e31822724f0","article-title":"Methadone, cocaine, opiates, and metabolite disposition in umbilical cord and correlations to maternal methadone dose and neonatal outcomes","volume":"33","author":"de Castro","year":"2011","journal-title":"Ther Drug Monit."},{"key":"R19-20230814","doi-asserted-by":"crossref","first-page":"h2102","DOI":"10.1136\/bmj.h2102","article-title":"Exposure to prescription opioid analgesics in utero and risk of neonatal abstinence syndrome: population based cohort study","volume":"350","author":"Desai","year":"2015","journal-title":"BMJ"},{"key":"R20-20230814","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.cll.2012.06.008","article-title":"Drug testing in the neonate","volume":"32","author":"Cotton","year":"2012","journal-title":"Clin Lab Med."},{"key":"R27-20230814","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.forsciint.2005.04.013","article-title":"Assessment of exposure to opiates and cocaine during pregnancy in a Mediterranean city: preliminary results of the \u201cMeconium project\u201d","volume":"153","author":"Pichini","year":"2005","journal-title":"Forensic Sci Int."},{"key":"R28-20230814","first-page":"637","article-title":"Comparing mothers\u2019 reports on the content of prenatal care received with recommended national guidelines for care","volume":"109","author":"Kogan","year":"1994","journal-title":"Public Health Rep."},{"key":"R30-20230814","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1038\/sj.jp.7210847","article-title":"Perinatal substance abuse intervention in obstetric clinics decreases adverse neonatal outcomes","volume":"23","author":"Armstrong","year":"2003","journal-title":"J Perinatol."},{"key":"R31-20230814","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1038\/jp.2008.70","article-title":"Substance abuse treatment linked with prenatal visits improves perinatal outcomes: a new standard","volume":"28","author":"Goler","year":"2008","journal-title":"J Perinatol."},{"key":"R32-20230814","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1111\/jrh.12174","article-title":"Neonatal abstinence syndrome in West Virginia substate regions, 2007-2013","volume":"33","author":"Stabler","year":"2017","journal-title":"J Rural Health."},{"key":"R33-20230814","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1097\/AOG.0000000000000208","article-title":"Increase in prescription opioid use during pregnancy among Medicaid-enrolled women","volume":"123","author":"Desai","year":"2014","journal-title":"Obstet Gynecol."},{"key":"R34-20230814","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.jsat.2014.07.007","article-title":"Recent trends in treatment admissions for prescription opioid abuse during pregnancy","volume":"48","author":"Martin","year":"2015","journal-title":"J Subst Abuse Treat."},{"key":"R35-20230814","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1097\/FTD.0b013e3181bb438e","article-title":"Identification of prenatal amphetamines exposure by maternal interview and meconium toxicology in the infant development, environment and lifestyle (IDEAL) study","volume":"31","author":"Gray","year":"2009","journal-title":"Ther Drug Monit."},{"key":"R36-20230814","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/S0022-3476(05)83509-7","article-title":"Adaptation of the meconium drug test for mass screening","volume":"122","author":"Ostrea","year":"1993","journal-title":"J Pediatr."},{"key":"R37-20230814","doi-asserted-by":"crossref","first-page":"951616","DOI":"10.1155\/2011\/951616","article-title":"Drug testing for newborn exposure to illicit substances in pregnancy: pitfalls and pearls","volume":"2011","author":"Farst","year":"2011","journal-title":"Int J Pediatr."},{"key":"R38-20230814","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1542\/peds.89.1.107","article-title":"Drug screening of newborns by meconium analysis: a large-scale, prospective, epidemiologic study","volume":"89","author":"Ostrea","year":"1992","journal-title":"Pediatrics"},{"key":"R39-20230814","first-page":"199","article-title":"Drug screening in newborns and mothers using meconium samples, paired urine samples, and interviews","volume":"15","author":"Bibb","year":"1995","journal-title":"J Perinatol."}],"container-title":["Therapeutic Drug Monitoring"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00007691-201712000-00010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T22:06:37Z","timestamp":1692050797000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00007691-201712000-00010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12]]},"references-count":30,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1097\/ftd.0000000000000447","relation":{},"ISSN":["0163-4356"],"issn-type":[{"value":"0163-4356","type":"print"}],"subject":[],"published":{"date-parts":[[2017,12]]}}}