183 A PROSPECTIVE STUDY COMPARING SYSTEMATIC INTERVIEW & ANALYSIS OF MATERNAL HAIR AND MECONIUM TO DETERMINE ILLICIT DRUG USE DURING PREGNANCY

Abstract

Accurate information on gestational, illicit drug use is important, yet difficult to obtain. An NIH funding allowed the prospective study of 52 pregnant drug users and 7 controls, throughout gestation, to determine their drug use by bimonthly interview and quantitative maternal hair [taken at enrollment (mean gestation = 18 wks), midgestation and delivery] and meconium (sampled for 3 days) analyses for cocaine (C), opiate (O) and cannabinoid (MJ) by RIA and confirmed by GC/MS. RESULTS: I. Meconium analysis had the highest sensitivity (Sn) and specificity (Sp) for C & O detection (Table). Hair analysis had as high Sn, but lower Sp (13-24% false positive) due to passive exposure. History had a 44% denial rate for C use. Hair and meconium analyses have low Sn (38-60%) for MJ detection. II. For amount of drug used, there was significant (p<0.001) correlation between the 3 tests for C use, and between history and hair, for O and MJ use. III. For timing of drug use, women who admitted to using C or O throughout gestation showed positive hair and meconium tests in all serial samples obtained. We conclude that meconium or hair analysis can sensitively detect many aspects of C & O use during gestation; however, meconium analysis is clearly advantageous, because it is noninvasive and highly more specific. Supported by NIDA (NIH) Grant 1 RO1 DA06821-01A1.