Retrospective analysis of the diagnostic yield of newborn drug testing (BMC Pregnancy and Childbirth)

Background: The objective of this study was to identify high-yield screening risk factors for detecting maternal non-medical drug use during pregnancy. Methods: A four year retrospective analysis was conducted at an academic medical center. Detailed chart review of both the newborn and mother`s medical record was performed on all cases for which one or more drug(s) or metabolite(s) were identified and confirmed in meconium or urine. Results: 229 (9.2%) of 2,497 meconium samples out of 7,749 live births confirmed positive for one or more non-medical drugs. History of maternal non-medical drug and/or tobacco use in pregnancy was present in 90.8% of non-medical drug use cases. Addition of social risk factors and inadequate prenatal care increased the yield to 96.9%. Conclusions: Use of focused screening criteria based on specific maternal and social risk factors may detect many prenatal non-medical drug exposures.