Sección de Toxicología, Instituto de Ciencias Forenses, Universidad de Santiago de Compostela, Santiago de Compostela, Spain.
Ther Drug Monit. 2013 Aug;35(4):502-9. doi: 10.1097/FTD.0b013e31828a6148.
Drug determination in biological matrices from the mother and the newborn is an objective measure of maternal and fetal drug exposure. The aim of this study was to compare maternal hair, meconium, umbilical cord, and placenta for detecting in utero drug exposure to cocaine, opiates, methadone, and amphetamines.
Maternal hair, meconium, umbilical cord, and placenta were collected from 175 mother-newborn dyads. Maternal hair (segmented in trimesters) and meconium specimens were analyzed for cocaine, opiates, methadone, and amphetamines. If either maternal hair or meconium tested positive, umbilical cord and placenta were analyzed. Analyses were performed by liquid chromatography tandem mass spectrometry.
In hair, 24 participants tested positive; 21 for cocaine [cocaine 20-50,605, benzoylecgonine (BE) 17-46,668 pg/mg], 7 for methadone (76-26,845 pg/mg), 2 for opiates (morphine 298-2398 pg/mg, codeine 65-914 pg/mg, 6-acetylmorphine 1635-15,657 pg/mg), and 1 for amphetamines (amphetamine 1990 pg/mg, 3,4-methylenedioxyamphetamine 30 pg/mg, 3,4-methylenedioxymethamphetamine 294 pg/mg). In meconium, 6 were positive; 5 for methadone [methadone 88-3752, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) 642-25,179 ng/g], 3 for cocaine (cocaine 7, BE 79, hydroxybenzoylecgonine 5-135, ecgonine-methyl ester 2-56 ng/g), and 2 for opiates (morphine 152-1025, morphine-3-glucuronide 22-23, codeine 4-34 ng/g). Placenta and umbilical cord were positive in 5 and 6 cases, respectively; 5 for methadone in placenta (methadone 7-543, EDDP 10-51 ng/g) and cord (methadone 3-183, EDDP 2-109 ng/g); 1 for cocaine in placenta (cocaine 7, BE 2 ng/g) and cord (BE 6 ng/g); and 1 for opiates in placenta (morphine 6, morphine-3-glucuronide 48 ng/g), and 2 in cord (morphine 2, morphine-3-glucuronide 15-38, morphine-6-glucuronide 5 ng/g). Meconium, placenta, and umbilical cord only tested positive if hair concentrations were greater than Society of Hair Testing cutoffs.
Maternal hair is the most sensitive specimen to detect drug consumption during pregnancy. Placenta and umbilical cord could be alternatives to meconium for detecting high in utero drug exposure.
从母亲和新生儿的生物基质中测定药物是衡量母体和胎儿药物暴露的客观指标。本研究的目的是比较母体毛发、胎粪、脐带和胎盘，以检测可卡因、阿片类药物、美沙酮和安非他命的宫内药物暴露。
从 175 对母婴对子中收集了母体毛发、胎粪、脐带和胎盘。对母体毛发（按妊娠三个月分段）和胎粪标本进行可卡因、阿片类药物、美沙酮和安非他命分析。如果母体毛发或胎粪检测呈阳性，则对脐带和胎盘进行分析。分析采用液相色谱-串联质谱法进行。
在毛发中，24 名参与者检测呈阳性；21 名可卡因阳性[可卡因 20-50,605，苯甲酰爱康宁（BE）17-46,668 pg/mg]，7 名美沙酮阳性[美沙酮 76-26,845 pg/mg]，2 名阿片类药物阳性（吗啡 298-2398 pg/mg，可待因 65-914 pg/mg，6-乙酰吗啡 1635-15,657 pg/mg），1 名安非他命阳性（安非他命 1990 pg/mg，3,4-亚甲二氧基苯丙胺 30 pg/mg，3,4-亚甲二氧基甲基苯丙胺 294 pg/mg）。胎粪中 6 例阳性；5 例美沙酮阳性[美沙酮 88-3752，2-亚乙基-1,5-二甲基-3,3-二苯基吡咯烷（EDDP）642-25,179 ng/g]，3 例可卡因阳性（可卡因 7，BE 79，羟基苯甲酰爱康宁 5-135，爱康宁-甲基酯 2-56 ng/g），2 例阿片类药物阳性（吗啡 152-1025，吗啡-3-葡糖苷酸 22-23，可待因 4-34 ng/g）。胎盘和脐带分别有 5 例和 6 例阳性；胎盘 5 例美沙酮阳性[美沙酮 7-543，EDDP 10-51 ng/g]和脐带 5 例美沙酮阳性[美沙酮 3-183，EDDP 2-109 ng/g]；胎盘 1 例可卡因阳性[可卡因 7，BE 2 ng/g]和脐带 1 例 BE 阳性[BE 6 ng/g]；胎盘 1 例阿片类药物阳性（吗啡 6，吗啡-3-葡糖苷酸 48 ng/g），脐带 2 例阿片类药物阳性（吗啡 2，吗啡-3-葡糖苷酸 15-38，吗啡-6-葡糖苷酸 5 ng/g）。只有当毛发浓度超过毛发检测协会的截止值时，胎粪、胎盘和脐带才会检测到药物。
母体毛发是检测妊娠期间药物使用的最敏感标本。胎盘和脐带可以替代胎粪，用于检测宫内药物暴露的高风险。
