MECONIUM DRUG SCREENING IN NEWBORN INFANTS

新生儿胎便药物筛查

• 批准号: 3213540
• 负责人: Enrique Mapua Ostrea
• 金额: $ 24.85万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-07-01 至 1993-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3213540
• 关键词: cannabinoids; cocaine; diagnostic tests; drug abuse; drug metabolism; drug screening /evaluation; embryo /fetus drug adverse effect; female; hair; human pregnant subject; human subject; interview; longitudinal human study; marijuana abuse; morphine; mother /infant health care; newborn human (0-6 weeks); placental transfer; pregnancy; questionnaires; radioimmunoassay; statistics /biometry

Recent epidemiological and other survey data suggest that a significant number of pregnant women and those in child bearing age abuse illicit drugs, in particular cocaine, with serious consequences such as premature delivery, low birth weight infants, high infant morbidity and long term sequelae. Therefore, it is important that these high risk infants are identified soon after birth, and it possible, the type, degree and duration of exposure to drugs, in utero. Currently, the methods used to accomplish this are by maternal self-report or by urine toxicology screen. Studies have shown that these methods do not consistently provide reliable and valid exposure data. A new method has been developed that identifies the drug exposed neonates by analysis of their stools (meconium) for drug metabolites. The test is quantitative, rapid, non invasive and by far, more sensitive than the current tests that are available. Since meconium, unlike urine, is not normally excreted by the fetus in utero, meconium accumulates in the fetus throughout gestation. Thus, further studies on meconium may provide details about the maternal drug such as the amount, timing and duration of her drug abuse. Comprehensive information of this nature are valuable for epidemiological and clinical purposes and are vital to our understanding of the complex relationship between drug use during pregnancy and its effects on the mother and fetus. The objective of this study is to determine whether the concentration of drug metabolites in meconium correlate to the amount, timing and duration of drug use by the mother. To accomplish this, a group of pregnant addicts who attend our maternal high risk clinic will be selected for follow up during pregnancy. The amount, time and duration of drug abuse by these subjects will be monitored throughout gestation by means of in depth interviews and by maternal hair analyses. Neither maternal nor infant urine will be tested for this purpose since these tests mostly reflect the recent use of drugs by the mother. After delivery, meconium that is serially passed by the infant will be analyzed for the metabolites of morphine, cocaine, and cannabinoid, three of the most common drugs of abuse. The individual and cumulative concentrations of each drug metabolite in meconium will be correlated to the maternal drug use as obtained from the interview and hair analysis. This study is designed to develop the potential of meconium drug analysis as a comprehensive diagnostic test. Currently, there is the need for an objective and sensitive test during the newborn period which can measure the type, amount, timing and duration of the infant's exposure to drugs in utero. An assessment of the potential to achieve this with the meconium analysis is proposed.

最近的流行病学和其他调查数据表明， 非法虐待孕妇和育龄妇女人数 毒品，特别是可卡因，会造成严重后果，例如早产 分娩、低出生体重婴儿、高婴儿发病率和长期 后遗症。 因此，重要的是这些高危婴儿 出生后不久就确定了，可能的类型、程度和持续时间 在子宫内接触药物。 目前，用于实现的方法 这是通过产妇自我报告或尿液毒理学筛查得出的。 研究 已经表明这些方法并不能始终如一地提供可靠和 有效的曝光数据。 已经开发出一种新方法来识别 通过分析粪便（胎便）中的药物来分析接触药物的新生儿 代谢物。 该测试是定量、快速、非侵入性的，到目前为止， 比当前可用的测试更敏感。 由于胎便， 与尿液不同，胎粪通常不会由子宫内的胎儿排出 在整个妊娠过程中会在胎儿体内积累。 因此，进一步研究 胎便可以提供有关母体药物的详细信息，例如剂量、 她滥用药物的时间和持续时间。 本次综合信息 自然对于流行病学和临床目的很有价值，并且至关重要 加深我们对药物使用之间复杂关系的理解 怀孕及其对母亲和胎儿的影响。 本研究的目的是确定浓度是否 胎便中的药物代谢物与数量、时间和持续时间相关 母亲吸毒的情况。 为了实现这一目标，一群怀孕的瘾君子 我们将选择到我们孕产妇高危诊所就诊的人进行随访 怀孕期间。 这些人滥用药物的数量、时间和持续时间 将通过深入监测受试者整个妊娠期 访谈和母亲头发分析。 无论是母婴还是婴儿 为此目的将测试尿液，因为这些测试主要反映 母亲最近使用过药物。 分娩后，胎便即 将分析婴儿连续通过的代谢物 吗啡、可卡因和大麻素是三种最常见的毒品 虐待。 每种药物的单独浓度和累积浓度 胎粪中的代谢物与母体药物使用相关，如下所示 从采访和头发分析中获得。 本研究旨在开发胎便药物分析的潜力 作为一项全面的诊断测试。 目前，需要一个 新生儿时期客观、灵敏的测试，可以测量 婴儿接触药物的类型、数量、时间和持续时间 子宫。 评估胎便实现这一目标的潜力 提出分析。