Rates of substance and polysubstance use through universal maternal testing at the time of delivery

Brittany L Smith; Eric S Hall; Jennifer M McAllister; Michael P Marcotte; Kenneth D R Setchell; Vandana Megaraj; Kristine L Jimenez; T John Winhusen; Scott L Wexelblatt

doi:10.1038/s41372-022-01335-3

Rates of substance and polysubstance use through universal maternal testing at the time of delivery

J Perinatol. 2022 Aug;42(8):1026-1031. doi: 10.1038/s41372-022-01335-3. Epub 2022 Feb 17.

Authors

Brittany L Smith¹, Eric S Hall^{2

3

4}, Jennifer M McAllister^{3

4

5}, Michael P Marcotte^{3

6}, Kenneth D R Setchell^{4

7}, Vandana Megaraj⁷, Kristine L Jimenez⁷, T John Winhusen^{5

8}, Scott L Wexelblatt^{9

10

11}

Affiliations

¹ Department of Pharmacology & Systems Physiology, University of Cincinnati Reading Campus, Cincinnati, OH, USA.
² Translational Data Science and Informatics, Geisinger, Danville, PA, USA.
³ Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
⁴ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
⁵ Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
⁶ Department of OB GYN, division of Maternal Fetal Medicine, TriHealth, Cincinnati, OH, USA.
⁷ Division of Pathology and Laboratory Medicine, Clinical Mass Spectrometry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
⁸ Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
⁹ Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. scott.wexelblatt@cchmc.org.
¹⁰ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. scott.wexelblatt@cchmc.org.
¹¹ Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA. scott.wexelblatt@cchmc.org.

Abstract

Objective: To report substance and polysubstance use at the time of delivery.

Study design: A cross-sectional study was performed on mothers consented for universal drug testing (99%) during hospital admission at six delivery hospitals in Cincinnati, Ohio. Mass spectrometry urinalysis detected positivity rates of 46 substances. Rates of positive drug tests for individual and common co-occurring substances measured were reported.

Results: 2531 maternal samples were tested (88%) and 33% contained cotinine, 11.3% THC, 7.2% opioids, 3.8% cocaine, and 1.9% methamphetamines. Polysubstance use prevalence was as high as 15%. Among mothers testing positive for methadone or buprenorphine, 93% also tested positive for cotinine and 39% tested positive for a third substance in addition to cotinine.

Conclusions: Substance use at delivery is more prevalent than previously reported. Many mothers testing positive for opioids also test positive for other substances, which may increase overdose risk and exacerbate neonatal opioid withdrawal syndrome (NOWS).

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Analgesics, Opioid / adverse effects
Buprenorphine* / therapeutic use
Cotinine
Cross-Sectional Studies
Female
Humans
Infant, Newborn
Opioid-Related Disorders* / diagnosis
Opioid-Related Disorders* / drug therapy
Opioid-Related Disorders* / epidemiology

Substances

Analgesics, Opioid
Buprenorphine
Cotinine

Grants and funding

K99 DA049908/DA/NIDA NIH HHS/United States