Retrospective analysis of the diagnostic yield of newborn drug testing

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.