Drug screening in newborns and mothers using meconium samples, paired urine samples, and interviews.

We evaluated the prevalence of illicit substance abuse by comparing drug screening results derived from meconium, urine pairs, and maternal interview. Mother/infant pairs (580) were entered into this blinded, prospective study. Prevalence of illicit substance abuse was 3.4%. The lack of prenatal care correlated with the use of cocaine (p < 0.001). Neonates born to cocaine-using mothers were more likely to be premature, to have a lower birth weight, decreased length, and smaller head circumference using unpaired t test (overall p < 0.05 using Bonferroni method for simultaneous inference). For mother/infant pairs who had positive drug screening for cocaine, the interview, maternal urine sample, and meconium sample showed equal sensitivity, although the newborn urine showed poor correlation. We suggest that the newborn urine sample could be deleted from newborn drug screening, and lack of perinatal care may serve as a marker of substance abuse.