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Rates of substance and polysubstance use through universal maternal testing at the time of delivery

Journal of Perinatology volume 42, pages 1026–1031 (2022)Cite this article

Subjects

Abstract

Objective

To report substance and polysubstance use at the time of delivery.

Study design

A cross-sectional study was performed on mothers consented for universal drug testing (99%) during hospital admission at six delivery hospitals in Cincinnati, Ohio. Mass spectrometry urinalysis detected positivity rates of 46 substances. Rates of positive drug tests for individual and common co-occurring substances measured were reported.

Results

2531 maternal samples were tested (88%) and 33% contained cotinine, 11.3% THC, 7.2% opioids, 3.8% cocaine, and 1.9% methamphetamines. Polysubstance use prevalence was as high as 15%. Among mothers testing positive for methadone or buprenorphine, 93% also tested positive for cotinine and 39% tested positive for a third substance in addition to cotinine.

Conclusions

Substance use at delivery is more prevalent than previously reported. Many mothers testing positive for opioids also test positive for other substances, which may increase overdose risk and exacerbate neonatal opioid withdrawal syndrome (NOWS).

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Fig. 1: Association between nicotine exposure and the detection of another substance.

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Acknowledgements

We would like to acknowledge financial support from Chiesi Farmaceutici S.p.A and Amgis Foundation, Inc.

Funding

In addition to financial support from Chiesi Farmaceutici S.p.A and Amgis Foundation, Inc., BLS is funded by the NIH/NIDA: K99DA049908.

Author information

Authors and Affiliations

  1. Department of Pharmacology & Systems Physiology, University of Cincinnati Reading Campus, Cincinnati, OH, USA

    Brittany L. Smith

  2. Translational Data Science and Informatics, Geisinger, Danville, PA, USA

    Eric S. Hall

  3. Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Eric S. Hall, Jennifer M. McAllister, Michael P. Marcotte & Scott L. Wexelblatt

  4. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Eric S. Hall, Jennifer M. McAllister, Kenneth D. R. Setchell & Scott L. Wexelblatt

  5. Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Jennifer M. McAllister, T. John Winhusen & Scott L. Wexelblatt

  6. Department of OB GYN, division of Maternal Fetal Medicine, TriHealth, Cincinnati, OH, USA

    Michael P. Marcotte

  7. Division of Pathology and Laboratory Medicine, Clinical Mass Spectrometry, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Kenneth D. R. Setchell, Vandana Megaraj & Kristine L. Jimenez

  8. Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    T. John Winhusen

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  1. Brittany L. Smith
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Contributions

BLS and SLW drafted the initial manuscript, along with conducting the investigation, formal analysis, and data curation. Study conceptualization and design were performed by ESH, JMM, TJW, MPM, and KDRS. Methodology was performed by BLS, SLW, ESH, JMM, VM, KLJ, and KDRS. Supervision/oversight for the investigation was conducted by SLW and KDRS. Funding was acquired by SLW and resources were provided by SLW and JMM. All authors assisted in reviewing or editing the manuscript, have given final approval of the version to be published, and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Scott L. Wexelblatt.

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Competing interests

We disclose that financial support for this work was provided by a grant from Chiesi Farmaceutici and a gift from Amgis Foundation, Inc. However, neither organization participated in study design, data collection, data analysis and interpretation, manuscript preparation, or the decision for manuscript submission. SLW has been a member of the speaker bureau for Abbott Nutrition in the past 2 years.

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Smith, B.L., Hall, E.S., McAllister, J.M. et al. Rates of substance and polysubstance use through universal maternal testing at the time of delivery. J Perinatol 42, 1026–1031 (2022). https://doi.org/10.1038/s41372-022-01335-3

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