脐带药物和可替宁水平与孕妇自我报告的药物使用和吸烟情况的一致性。
Agreement of umbilical cord drug and cotinine levels with maternal self-report of drug use and smoking during pregnancy.
机构信息
Department of Obstetrics, Gynecology and Women's Health, University of Hawaii John A Burns School of Medicine, Honolulu, HI 96826, USA.
出版信息
J Perinatol. 2011 May;31(5):324-9. doi: 10.1038/jp.2010.132. Epub 2010 Dec 9.
Abstract
OBJECTIVE
We undertook this study to assess the agreement between fetal umbilical cord drug levels and maternal self-report.
STUDY DESIGN
Cord samples were collected from 103 placentas after delivery as a subproject of the larger Pacific Research Center for Early Human Development (PRCEHD) study. These cord samples were then processed to obtain cord lysates and enzyme-linked immunosorbent assay (ELISA) performed for cotinine and illicit drugs. Levels of each of these substances were compared with clinical information.
RESULT
We found fair agreement between self-reported smoking and cotinine levels (κ = 0.26 (0.07 to 0.5)) as well as slight agreement with current drug use and positive drug levels (κ = 0.19 (-0.05 to 0.4)). Compared with maternal self-report, sensitivity of cotinine levels was 27% and specificity was 98%. Sensitivity of positive cord illicit drug levels was 32% and specificity was 85%.
CONCLUSION
Umbilical cords provide another independent measure of maternal drug use and are readily available. To our knowledge, this is the first study to measure cotinine levels in the umbilical cord tissue.
摘要
目的
我们开展这项研究旨在评估胎儿脐带药物水平与母亲自我报告之间的一致性。
研究设计
作为大型太平洋早期人类发育研究中心（PRCEHD）研究的子项目，在分娩后从 103 个胎盘收集脐带样本。然后对这些脐带样本进行处理以获得脐带裂解物，并进行酶联免疫吸附测定（ELISA）以检测可替宁和非法药物。将这些物质的水平与临床信息进行比较。
结果
我们发现自我报告的吸烟和可替宁水平之间存在适度的一致性（κ=0.26（0.07 至 0.5）），以及当前药物使用和阳性药物水平之间的轻度一致性（κ=0.19（-0.05 至 0.4））。与母亲的自我报告相比，可替宁水平的敏感性为 27%，特异性为 98%。阳性脐带非法药物水平的敏感性为 32%，特异性为 85%。
结论
脐带为衡量母亲药物使用情况提供了另一种独立的测量方法，且容易获得。据我们所知，这是首次在脐带组织中测量可替宁水平的研究。
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