Abstract:
:In pregnancy, opioids may be used medically and also misused. We hypothesized that the umbilical cord (UC) could be a good screening tool for determining opioid exposure and improving medical care. One hundred and one UC, each with 50 associated ICD9/ICD10 codes were used. Using predictive pharmacokinetic analysis we determined that opioids could be detected since last ingestion prior to birth. The UC were lysed and screened using ELISA detecting multiple opioids and their metabolites. Statistical comparisons to obstetric and neonatal outcomes were performed. Although the commercial ELISA was less sensitive in UC than blood or urine, there was perfect method selectivity as compared to a subset of cords designated positive or negative by clinical diagnostics, so our results are accurate and reliable. Absolute quantitation was not possible because the antibody cross reacts with multiple compounds, but 'low' or 'high' levels of exposure were assigned. Prevalence of opioids was 11%, which reduced to 7% when cesarean-section births were eliminated. For non-cesarean-section infants adjusted for preterm birth, advanced maternal age and smoking (independent risk factors), opioids were significantly associated with intra-uterine growth restriction (p = 0.017) and admission to neonatal intensive care (p = 0.002). UC can be collected noninvasively and rapidly providing a reliable tools for semi-quantitative opioid screening using ELISA. Moreover, as UC are usually discarded collection presents few technical or safety concerns for staff or patients. Further development of this methodology may provide a rapid, noninvasive clinical screening tool to identify NAS and/or opioid use in late pregnancy.
journal_name
Toxicol Mech Methodsjournal_title
Toxicology mechanisms and methodsauthors
Knight SJ,Smith AD,Wright TE,Collier ACdoi
10.1080/15376516.2018.1506850subject
Has Abstractpub_date
2019-01-01 00:00:00pages
35-42issue
1eissn
1537-6516issn
1537-6524journal_volume
29pub_type
杂志文章abstract::For good performance in clinical and forensic toxicology, it is important to be aware of the signs and symptoms related to xenobiotic exposure since they will assist clinicians to reach a useful and rapid diagnosis. This manuscript highlights and critically analyses clinical and forensic imaging related to ethanol abu...
journal_title:Toxicology mechanisms and methods
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journal_title:Toxicology mechanisms and methods
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journal_title:Toxicology mechanisms and methods
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journal_title:Toxicology mechanisms and methods
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journal_title:Toxicology mechanisms and methods
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journal_title:Toxicology mechanisms and methods
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journal_title:Toxicology mechanisms and methods
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