Does Rowan County Nc Drug Test Babies at Birth
Indications for Testing
Newborn drug testing is recommended in infants built-in to mothers with loftier-risk behaviors (eg, history of drug use/abuse, prostitution, nicotine utilize), minimal or no prenatal care, or unexplained obstetric events (eg, placental abruption, premature labor).
Additionally, infants with unexplained neurologic complications, unexpected intrauterine growth retardation, or drug withdrawal symptoms (eg, NAS) should exist tested for drug exposure.
Available Specimen Types
ARUP offers newborn drug testing for two specimen types: umbilical cord tissue and meconium. Urine as a specimen type for neonatal drug testing has limited success; the outset void is frequently missed because it may occur during or immediately after delivery. Urine tests generally detect only recent maternal drug use in the days earlier delivery.
| Meconium | Umbilical Cord Tissue |
|---|---|
| Outset stool of the newborn Begins to form at ~12-16 wks gestation Accumulates over residue of pregnancy (nonlinear process) Unremarkably passes within 48 hrs of nascence Used for drug testing for ~25 yrs Collection requires coordinated efforts and may non be available Drug detection in meconium depends on many factors (eg, quality and completeness of collection, drug use patterns) | Forms ~5th wk of gestation Grows with fetus throughout pregnancy (nonlinear process) Easy to collect at time of birth Drugs appear to deposit consistently across length of cord Concentrations of drug analytes are lower in cord than in meconium, just can be detected with appropriate methodology Drug detection in string tissue depends on many factors (eg, quality and completeness of collection, drug employ patterns) |
| NOTE: Umbilical cord tissue and meconium drug tests are performed to support clinical and social management decisions and do non ordinarily require chain of custody. ARUP offers a specimen tracking course for documentation of the collection, handling, and shipping of specimens. Contact ARUP Client Services for more than information. Sources: Wabuyele, 2018 ; Wu, 2018 | |
There are several factors to consider when deciding whether to utilize umbilical cord tissue or meconium for drug testing.
| Factors to Consider | Umbilical String Tissue | Meconium |
|---|---|---|
| Preferred procedure for collection is at nativity, for all infants; test immediately for high-chance births, shop for depression-gamble births | ✔ | |
| Collection based on need (eg, history of drug exposure, maternal urine screen results, NAS symptoms/diagnosis) | ✔ | ✔ |
| Tracking of specimen collection and handling process required | ✔ | ✔ |
| Fastest available fourth dimension to issue when positive results are expected | ✔ | |
| Traditional testing approach (screen with reflex to confirmation testing) preferred | ✔ | |
| Near sensitive and definitive testing for cannabis use | ✔ | |
| Near sensitive and definitive testing for heroin use | ✔ | |
| Preferred for the detection of gabapentin, fentanyl, meperidine, propoxyphene, tramadol, tapentadol, phentermine, and/or zolpidem | ✔ | |
| Meconium specimen is limited or unavailable | ✔ | |
| Cord tissue specimen is limited or unavailable | ✔ |
ARUP Umbilical Cord Tissue Testing
Routine analysis by the ARUP drug detection console includes qualitative detection past mass spectrometric methods for all compounds (eg, opioids, stimulants, sedative-hypnotics). The presence of metabolites improves confidence in results and lengthens the detection window. Umbilical cord testing is thought to reflect maternal drug use during approximately the concluding trimester of a full-term birth. Tests to detect marijuana metabolite and ethyl glucuronide (alcohol metabolite) are bachelor separately from the panel.
Farther Resources
- Umbilical string tissue drove instructions
- Umbilical cord tissue collection video
- Test Fact Sheets: ARUP Drug Detection Console, Umbilical Cord Tissue (Qualitative) and Ethyl Glucuronide, Umbilical Cord Tissue, Qualitative
ARUP Meconium Testing
Routine analysis by the ARUP panel test includes a qualitative screen for nine drug classes; specimens that test positive for one or more than drugs are reflexed to confirmatory testing past highly sensitive and specific mass spectrometric methods. Directed (confirmation only) tests are available when merely 1 drug class is of clinical interest or when the quantity of meconium available for testing is very small-scale (ie, <1 g).
The panel is the preferred meconium test to find and document maternal drug apply during pregnancy (approximately the terminal trimester of a full-term nativity). Targeted single drug-grade testing is appropriate if merely a particular drug grade or classes are of clinical involvement, or when the quantity of meconium bachelor for testing is very small (ie, <1 g).
Evaluation and Interpretation of Results
Drugs administered to the mother during labor and delivery may be detected in meconium or umbilical cord tissue. Drugs administered to the newborn after birth may be detected in meconium if the meconium is collected later drug administration.
Negative results do non exclude the possibility that the mother used drugs during pregnancy; but the drugs targeted past the testing can be detected. Maternal history and urine testing may too identify a possible baby drug exposure and should be used in combination with other laboratory results and the baby's clinical presentation to diagnose a drug exposure.
Specimen variations can contribute to false-negative results. When definitive analytical methods (eg, liquid chromatography-tandem mass spectrometry [LC-MS/MS], gas chromatography-mass spectrometry [GC-MS]) are used, false-positive results are extremely unlikely.
Refer to the Drug Testing topic for test result interpretation organized by drug class.
Further Resources
Opioid Metabolic Pathway
Benzodiazepine Metabolic Pathway
Source: https://arupconsult.com/content/newborn-drug-testing
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