Newark, NJ is one of the nation's oldest industrial cities. While there have been improvements in the local economy, poverty and its associated problems, including drug abuse, are still entrenched in many areas. Accordingly, it is expected that some newborns will enter the world having been exposed to drugs of abuse before their life begins. Each year, some 2,000 children are born at the Newark-based University of Medicine and Dentistry of New Jersey/New Jersey Medical School (UMDNJ/NJMS) and its affiliated clinical teaching institution, University Hospital. When clinically appropriate, a urine sample is taken from the infant and sent to the hospital laboratory for drug testing. It requires between 24-48 hours to complete the test and deliver results to the neonatologist or pediatrician. In an attempt to develop more rapid results and gain a better understanding of the extent of the problem, a team of researchers utilized an investigational product to test 101 infants born at UMDNJ/NJMS for the presence of drugs of abuse.
Kenneth W. Lieberman, Salma Ali and George Alexander, all of the UMDNJ/NJMS and University Hospital, conducted the study, "Laboratory Testing of Neonates Exposed to Drugs of Abuse." The researchers will present their findings in full during the American Physiological Society's (APS) annual meeting, part of the "Experimental Biology 2002" conference. More than 12,000 attendees will attend the conference being held at the Ernest N. Morial Convention Center, New Orleans, LA from April 20-24, 2002.
A total of 101 infants were included in the study that was conducted over a three-month period conducted in 1998. The identity of the newborn was coded to assure complete anonymity, even to the research team.
Urine was collected from the infants and tested for the presence of cocaine, opiates, amphetamines, phencyclidine, barbiturates, benzodiazepines, cannabinoids and propoxyphene. Testing consisted of one of two methods. The first used the investigational tool designed to evaluate samples at the bedside and provide rapid results. The other method used a national reference lab to perform the analyses. The reference lab results were used as the standard by which the accuracy of the rapid-test technology was determined.
The results from the rapid bedside technology were shown to be worthwhile, even though less accurate than those evaluated by the reference lab. With respect to the identification of drugs in the newborns, the results showed:
- A total of 60 newborns tested negative compared to 41 who tested positive.
- Of the 41 infants testing positive, 22 infants were positive for two or more drugs; l9 were positive for one drug.
- Cocaine was present in 38 samples.
- Heroin was present in 22 samples.
Drugs of abuse can cause a variety of serious medical problems to the fetus during pregnancy and after delivery. For this reason the investigators support more funding for rapid-screening technology for use with infants. By knowing the status of these infants early, neonatologists and pediatricians can begin effective medical treatment without delay.
As cocaine and heroin were the major abused drugs in the pregnant women, better educational efforts aimed at this population are necessary, the researchers say. The benefits accrue not only to the mother's health and the infant's well-being, but to the community at large since the costs associated with delivering and caring for a newborn that has not been exposed to drugs of abuse are significantly less than the costs associated with those infants who have been.
