Skip to main content
PMC home page
Archives of Disease in Childhood. Fetal and Neonatal Edition logoLink to Archives of Disease in Childhood. Fetal and Neonatal Edition
. 2003 Mar;88(2):F98–F100. doi: 10.1136/fn.88.2.F98

Comparison of meconium and neonatal hair analysis for detection of gestational exposure to drugs of abuse

B Bar-Oz, J Klein, T Karaskov, G Koren
PMCID: PMC1721515  PMID: 12598495

Abstract

Background: Meconium and hair are two biological markers of in utero exposure to illicit drugs.

Objective: To compare the sensitivity of the two tests for different drugs.

Setting: Motherisk laboratory which tests in utero drug exposure in Toronto.

Methods: Cocaine, benzoylecgonine, opiates, cannabis, benzodiazepines, methadone, and barbiturates were measured in pairs of hair and meconium samples from the same neonates.

Results: Meconium was marginally more sensitive than neonatal hair for detection of cocaine and cannabis, possibly because it may detect second trimester exposure whereas hair grows only during the third trimester of pregnancy. There was a significant correlation between hair and meconium concentrations of cocaine, cannabis, and opiates.

Conclusion: In cases of clinical suspicion and a negative neonatal urine test, both meconium and hair are effective biological markers of in utero illicit drug exposure. Meconium may be more sensitive, but neonatal hair is available for three months whereas meconium is available for only one or two days. In contrast, the use of meconium, being a discarded material, is more acceptable to some parents than hair testing, which entails cutting scalp hair from the newborn.

Full Text

The Full Text of this article is available as a PDF (81.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Addis A., Moretti M. E., Ahmed Syed F., Einarson T. R., Koren G. Fetal effects of cocaine: an updated meta-analysis. Reprod Toxicol. 2001 Jul-Aug;15(4):341–369. doi: 10.1016/s0890-6238(01)00136-8. [DOI] [PubMed] [Google Scholar]
  2. Birchfield M., Scully J., Handler A. Perinatal screening for illicit drugs: policies in hospitals in a large metropolitan area. J Perinatol. 1995 May-Jun;15(3):208–214. [PubMed] [Google Scholar]
  3. Chasnoff I. J., Bussey M. E., Savich R., Stack C. M. Perinatal cerebral infarction and maternal cocaine use. J Pediatr. 1986 Mar;108(3):456–459. doi: 10.1016/s0022-3476(86)80896-4. [DOI] [PubMed] [Google Scholar]
  4. Chasnoff I. J., Griffith D. R. Cocaine: clinical studies of pregnancy and the newborn. Ann N Y Acad Sci. 1989;562:260–266. doi: 10.1111/j.1749-6632.1989.tb21024.x. [DOI] [PubMed] [Google Scholar]
  5. Chiriboga C. A., Bateman D. A., Brust J. C., Hauser W. A. Neurologic findings in neonates with intrauterine cocaine exposure. Pediatr Neurol. 1993 Mar-Apr;9(2):115–119. doi: 10.1016/0887-8994(93)90045-e. [DOI] [PubMed] [Google Scholar]
  6. Chiriboga C. A., Brust J. C., Bateman D., Hauser W. A. Dose-response effect of fetal cocaine exposure on newborn neurologic function. Pediatrics. 1999 Jan;103(1):79–85. doi: 10.1542/peds.103.1.79. [DOI] [PubMed] [Google Scholar]
  7. Cirimele V., Kintz P., Mangin P. Testing human hair for cannabis. Forensic Sci Int. 1995 Jan 5;70(1-3):175–182. doi: 10.1016/0379-0738(94)01615-c. [DOI] [PubMed] [Google Scholar]
  8. Delaney-Black V., Covington C., Ostrea E., Jr, Romero A., Baker D., Tagle M. T., Nordstrom-Klee B., Silvestre M. A., Angelilli M. L., Hack C. Prenatal cocaine and neonatal outcome: evaluation of dose-response relationship. Pediatrics. 1996 Oct;98(4 Pt 1):735–740. [PubMed] [Google Scholar]
  9. Dixon S. D. Effects of transplacental exposure to cocaine and methamphetamine on the neonate. West J Med. 1989 Apr;150(4):436–442. [PMC free article] [PubMed] [Google Scholar]
  10. Dolovich L. R., Addis A., Vaillancourt J. M., Power J. D., Koren G., Einarson T. R. Benzodiazepine use in pregnancy and major malformations or oral cleft: meta-analysis of cohort and case-control studies. BMJ. 1998 Sep 26;317(7162):839–843. doi: 10.1136/bmj.317.7162.839. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Forman R., Klein J., Meta D., Barks J., Greenwald M., Koren G. Maternal and neonatal characteristics following exposure to cocaine in Toronto. Reprod Toxicol. 1993 Nov-Dec;7(6):619–622. doi: 10.1016/0890-6238(93)90039-a. [DOI] [PubMed] [Google Scholar]
  12. Franck L., Vilardi J. Assessment and management of opioid withdrawal in ill neonates. Neonatal Netw. 1995 Mar;14(2):39–48. [PubMed] [Google Scholar]
  13. Frank D. A., Augustyn M., Knight W. G., Pell T., Zuckerman B. Growth, development, and behavior in early childhood following prenatal cocaine exposure: a systematic review. JAMA. 2001 Mar 28;285(12):1613–1625. doi: 10.1001/jama.285.12.1613. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Gillogley K. M., Evans A. T., Hansen R. L., Samuels S. J., Batra K. K. The perinatal impact of cocaine, amphetamine, and opiate use detected by universal intrapartum screening. Am J Obstet Gynecol. 1990 Nov;163(5 Pt 1):1535–1542. doi: 10.1016/0002-9378(90)90621-d. [DOI] [PubMed] [Google Scholar]
  15. Graham K., Koren G., Klein J., Schneiderman J., Greenwald M. Determination of gestational cocaine exposure by hair analysis. JAMA. 1989 Dec 15;262(23):3328–3330. [PubMed] [Google Scholar]
  16. Jekel J. F., Allen D. F., Podlewski H., Clarke N., Dean-Patterson S., Cartwright P. Epidemic free-base cocaine abuse. Case study from the Bahamas. Lancet. 1986 Mar 1;1(8479):459–462. doi: 10.1016/s0140-6736(86)92926-0. [DOI] [PubMed] [Google Scholar]
  17. Klein J., Karaskov T., Koren G. Clinical applications of hair testing for drugs of abuse--the Canadian experience. Forensic Sci Int. 2000 Jan 10;107(1-3):281–288. doi: 10.1016/s0379-0738(99)00171-1. [DOI] [PubMed] [Google Scholar]
  18. Koren G., Klein J., Forman R., Graham K. Hair analysis of cocaine: differentiation between systemic exposure and external contamination. J Clin Pharmacol. 1992 Jul;32(7):671–675. doi: 10.1002/j.1552-4604.1992.tb05780.x. [DOI] [PubMed] [Google Scholar]
  19. Lopez S. L., Taeusch H. W., Findlay R. D., Walther F. J. Time of onset of necrotizing enterocolitis in newborn infants with known prenatal cocaine exposure. Clin Pediatr (Phila) 1995 Aug;34(8):424–429. doi: 10.1177/000992289503400805. [DOI] [PubMed] [Google Scholar]
  20. Ostrea E. M., Jr, Knapp D. K., Tannenbaum L., Ostrea A. R., Romero A., Salari V., Ager J. Estimates of illicit drug use during pregnancy by maternal interview, hair analysis, and meconium analysis. J Pediatr. 2001 Mar;138(3):344–348. doi: 10.1067/mpd.2001.111429. [DOI] [PubMed] [Google Scholar]
  21. Ursitti F., Klein J., Sellers E., Koren G. Use of hair analysis for confirmation of self-reported cocaine use in users with negative urine tests. J Toxicol Clin Toxicol. 2001;39(4):361–366. doi: 10.1081/clt-100105156. [DOI] [PubMed] [Google Scholar]
  22. Volpe J. J. Effect of cocaine use on the fetus. N Engl J Med. 1992 Aug 6;327(6):399–407. doi: 10.1056/NEJM199208063270607. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood Fetal and Neonatal Edition are provided here courtesy of BMJ Publishing Group

RESOURCES