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Marchei E, Gomez-Ruiz LM, Acosta-López A, Ramos-Gutiérrez RY, Varela-Busaka MB, Lombroni C, Andreu-Fernandez V, Pichini S, Garcia-Algar O. Assessment of alcohol consumption in mexican pregnant women by hair testing of ethyl glucuronide. Alcohol 2023; 111:59-65. [PMID: 37302618 DOI: 10.1016/j.alcohol.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/09/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023]
Abstract
There are no studies that have utilized both biomarkers and self-reported data to evaluate maternal alcohol use during pregnancy in Mexico. Therefore, we aimed to describe the prevalence of alcohol consumption in a cohort of 300 Mexican pregnant women. We used a validated ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method to measure hair ethyl glucuronide (EtG) in hair segments that corresponded to the first and second half of pregnancy. We compared the hair EtG values to a self-reported questionnaire on maternal drinking habits and evaluated whether the gestational alcohol use was associated with psychotropic drug use. Based on the EtG measurements, 263 women (87.7%) were alcohol-abstinent during the entire pregnancy, while 37 (12.3%) had used alcohol at least once during the pregnancy. Of these, only two women were found to have problematic alcoholic behavior during the entire pregnancy. No significant differences in sociodemographic characteristics were observed between alcohol-abstinent women and women with drinking habits. The self-reporting data and hair EtG gave heterogeneous results: although 37 women had self-reported alcohol use during pregnancy, only 54.1% of these women tested positive for hair EtG. Of the women who tested positive for hair EtG, 54.1% tested positive for psychoactive substances. In our cohort, the use of drugs of abuse was independent of gestational drinking. This study provided the first objective evidence of prenatal ethanol consumption in a cohort of Mexican pregnant women.
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Affiliation(s)
- Emilia Marchei
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, V.Le Regina Elena 299, 00161 Rome, Italy
| | - Larissa-Maria Gomez-Ruiz
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico; Departamento de Cirugía y Especialidades Médico-quirúrgicas, Universidad de Barcelona, Barcelona, Spain
| | - Aracely Acosta-López
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | - Ruth-Yesica Ramos-Gutiérrez
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | - Mary-Buhya Varela-Busaka
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | - Claudia Lombroni
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, V.Le Regina Elena 299, 00161 Rome, Italy; Univesità Degli Studi di Torino, Via Pietro Giuria 5, 10125, Torino, Italy
| | - Vicente Andreu-Fernandez
- Grup de Recerca Infancia i Entorn (GRIE), Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; Faculty of Health Sciences, Valencian International University (VIU), 46002 Valencia, Spain
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, V.Le Regina Elena 299, 00161 Rome, Italy.
| | - Oscar Garcia-Algar
- Departamento de Cirugía y Especialidades Médico-quirúrgicas, Universidad de Barcelona, Barcelona, Spain; Grup de Recerca Infancia i Entorn (GRIE), Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; Neonatology Unit, Hospital Clinic-Maternitat, ICGON, BCNatal, C/Sabino Arana 1, 08028 Barcelona, Spain.
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Roca A, Jarque P, Gomila I, Marchei E, Tittarelli R, Elorza MÁ, Sanchís P, Barceló B. Clinical features and risk factors associated with prenatal exposure to drugs of abuse. An Pediatr (Barc) 2021; 95:307-320. [PMID: 34635463 DOI: 10.1016/j.anpede.2020.08.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/03/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Early identification of neonates exposed to drugs of abuse during pregnancy allows a more precise clinical management. OBJECTIVES To describe the clinical characteristics and to identify risk factors associated with the early detection of neonates exposed to drugs of abuse in a Neonatal Intermediate and Intensive Care Unit. METHODS Prospective observational study of neonates with and without clinical suspicion of prenatal exposure to drugs of abuse. Meconium was analyzed using standard chromatographic techniques. Univariate and multivariate statistical analyzes were performed. RESULTS 372 neonates were included. Exposure to drugs of abuse was detected in 49 (13.2%) cases: in 41 (83.7%) one drug and in 8 (16.3%) more than one. Somatometry at birth revealed: a) lower length percentile in those exposed to some drug, more than one and cannabis; b) lower weight percentile in those exposed to cannabis and of these compared to those exposed to alcohol. In neonates older than 34 pregnancy weeks (PW): a) lower length percentile in those exposed to any substance; b) lower percentile of length and weight in exposed to more than one. The most clinically relevant independent risk factors useful to detect cases of prenatal exposure to drugs of abuse were (Odds ratio (95% CI)): reason for admission other than prematurity (5.52 (2.55-1.93)), length percentile less than 33 (1.95 (1.05-3.60) and 2.14 (1.04-3.40) in older than 34 PW) and social dystocia/uncontrolled pregnancy in older than 34 PW (4.47 (1.03-19.29)). CONCLUSIONS There are somatometric alterations and risk factors that can help in the early detection of neonates exposed to drugs of abuse. The somatometric alterations identified can be useful to extend the differential diagnosis of these alterations and to study their causes.
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Affiliation(s)
- Antonia Roca
- Unidad de Neonatología, Servicio de Pediatría, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Pilar Jarque
- Unidad de Neonatología, Servicio de Pediatría, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Isabel Gomila
- Servicio de Análisis Clínicos, Hospital Universitario Son Llàtzer, Palma de Mallorca, Spain; Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, Spain
| | - Emilia Marchei
- Centro Nacional de Adicciones y Dopaje, Instituto Superior de Salud, Roma, Italy
| | - Roberta Tittarelli
- Unidad de Toxicología Forense, Departamento de Ciencias Anatómicas, Histológicas, Forenses y Ortopédicas, Universidad de Sapienza, Roma, Italy
| | - Miguel Ángel Elorza
- Servicio de Análisis Clínicos, Unidad de Toxicología Clínica, Hospital Universitario Son Espases, Palma de Mallorca, Spain; Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, Spain
| | - Pilar Sanchís
- Departamento de Química, Universidad de las Islas Baleares, Palma de Mallorca, Spain; Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, Spain
| | - Bernardino Barceló
- Servicio de Análisis Clínicos, Unidad de Toxicología Clínica, Hospital Universitario Son Espases, Palma de Mallorca, Spain; Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, Spain.
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Jarque P, Roca A, Gomila I, Marchei E, Tittarelli R, Elorza MÁ, Sanchís P, Barceló B. Role of Neonatal Biomarkers of Exposure to Psychoactive Substances to Identify Maternal Socio-Demographic Determinants. BIOLOGY 2021; 10:biology10040296. [PMID: 33916618 PMCID: PMC8067052 DOI: 10.3390/biology10040296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/29/2021] [Accepted: 04/01/2021] [Indexed: 11/16/2022]
Abstract
Simple Summary The rapid identification of newborns exposure to psychoactive drugs allows an appropriate clinical care. This study tried to identify maternal profiles that help to identify newborns exposed to psychoactive drugs during pregnancy. Mothers were interviewed using a questionnaire. The biomarkers of fetal exposure were measured in meconium samples. Statistical analysis was performed to identify the maternal characteristics that were most likely to be associated with drug use during pregnancy. Of a total of 372 mothers, 49 (13.2%) tested positive for psychoactive drugs use: 24 (49.0%) for cannabis, 11 (22.5%) for ethyl glucuronide, six (12.2%) for cocaine, and eight (16.3%) for more than one psychoactive substance. The maternal characteristics that most likely identify substance use during pregnancy are: maternal age < 24 years, lack of pregnancy care, single-mother families, and active tobacco smoking. The profiles of prenatal maternal exposure identified in a clinical setting can be used to request specific detection tests for identifying newborns exposed to these drugs. Abstract Background: The accurate assessment of fetal exposure to psychoactive substances provides the basis for appropriate clinical care of neonates. The objective of this study was to identify maternal socio-demographic profiles and risk factors for prenatal exposure to drugs of abuse by measuring biomarkers in neonatal matrices. Methods: A prospective, observational cohort study was completed. Biomarkers of fetal exposure were measured in meconium samples. The mothers were interviewed using a questionnaire. Univariate and multivariate logistic regression analyses were performed. Results: A total of 372 mothers were included, 49 (13.2%) testing positive for psychoactive substances use: 24 (49.0%) for cannabis, 11 (22.5%) for ethyl glucuronide, six (12.2%) for cocaine, and in eight (16.3%) more than one psychoactive substance. Mothers who consumed any psychoactive substance (29.7 ± 6.6 years) or cannabis (27.0 ± 5.7 years) were younger than non-users (32.8 ± 6.2 years, p < 0.05). Cocaine (50.0% vs. 96.9%, p < 0.05) and polydrug users (37.5% vs. 96.9%, p < 0.05) showed a lower levels of pregnancy care. Previous abortions were associated with the use of two or more psychoactive substances (87.5% vs. 37.8%, p < 0.05). Single-mother families (14.3% vs. 2.5%, p < 0.05) and mothers with primary level education (75.5% vs. 55.1%, p < 0.05) presented a higher consumption of psychoactive substances. Independent risk factors that are associated with prenatal exposure include: maternal age < 24 years (odds ratio: 2.56; 95% CI: 1.12–5.87), lack of pregnancy care (odds ratio: 7.27; 95%CI: 2.51–21.02), single-mother families (odds ratio: 4.98; 95%CI: 1.37–8.13), and active tobacco smoking (odds ratio: 8.13; 95%CI: 4.03–16.43). Conclusions: These results will allow us to develop several risk-based drug screening approaches to improve the early detection of exposed neonates.
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Affiliation(s)
- Pilar Jarque
- Department of Pediatrics, Division of Neonatology, Son Espases University Hospital, Valldemossa Road, 79, 07120 Palma de Mallorca, Spain; (P.J.); (A.R.)
- Pediatric Multidisciplinary Research Group, Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, 07120 Palma de Mallorca, Spain
| | - Antonia Roca
- Department of Pediatrics, Division of Neonatology, Son Espases University Hospital, Valldemossa Road, 79, 07120 Palma de Mallorca, Spain; (P.J.); (A.R.)
- Pediatric Multidisciplinary Research Group, Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, 07120 Palma de Mallorca, Spain
| | - Isabel Gomila
- Clinical Analysis Service, Son Llàtzer University Hospital, Manacor Road, 07198 Palma de Mallorca, Spain;
- Clinical Toxicology Research Group, Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, 07120 Palma de Mallorca, Spain;
| | - Emilia Marchei
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Rome, Italy;
| | - Roberta Tittarelli
- Department of Anatomical, Unit of Forensic Toxicology, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185 Rome, Italy;
| | - Miguel Ángel Elorza
- Clinical Toxicology Research Group, Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, 07120 Palma de Mallorca, Spain;
- Clinical Analysis Service, Clinical Toxicology Unit, Son Espases University Hospital, Valldemossa Road, 79, 07120 Palma de Mallorca, Spain
| | - Pilar Sanchís
- Department of Chemistry, University of the Balearic Islands, Valldemossa Road, km 7.5, 07122 Palma de Mallorca, Spain;
- Research Group in Vascular and Metabolic Pathologies, Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, 07120 Palma de Mallorca, Spain
| | - Bernardino Barceló
- Clinical Toxicology Research Group, Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, 07120 Palma de Mallorca, Spain;
- Clinical Analysis Service, Clinical Toxicology Unit, Son Espases University Hospital, Valldemossa Road, 79, 07120 Palma de Mallorca, Spain
- Correspondence: ; Tel.: +34-871205000 (ext. 65476)
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Roca A, Jarque P, Gomila I, Marchei E, Tittarelli R, Elorza MÁ, Sanchís P, Barceló B. [Clinical features and risk factors associated with prenatal exposure to drugs of abuse]. An Pediatr (Barc) 2020; 95:S1695-4033(20)30285-X. [PMID: 33041240 DOI: 10.1016/j.anpedi.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION Early identification of neonates exposed to drugs of abuse during pregnancy allows a more precise clinical management. OBJECTIVES To describe the clinical characteristics and to identify risk factors associated with the early detection of neonates exposed to drugs of abuse in a Neonatal Intermediate and Intensive Care Unit. METHODS Prospective observational study of neonates with and without clinical suspicion of prenatal exposure to drugs of abuse. Meconium was analyzed using standard chromatographic techniques. Univariate and multivariate statistical analyzes were performed. RESULTS 372 neonates were included. Exposure to drugs of abuse was detected in 49 (13.2%) cases: in 41 (83.7%) one drug and in 8 (16.3%) more than one. Somatometry at birth revealed: a) lower length percentile in those exposed to some drug, more than one and cannabis; b) lower weight percentile in those exposed to cannabis and of these compared to those exposed to alcohol. In neonates older than 34 pregnancy weeks (PW): a) lower length percentile in those exposed to any substance; b) lower percentile of length and weight in exposed to more than one. The most clinically relevant independent risk factors useful to detect cases of prenatal exposure to drugs of abuse were (Odds ratio (95% CI)): reason for admission other than prematurity (5.52 (2.55-1.93)), length percentile less than 33 (1.95 (1.05-3.60) and 2.14 (1.04-3.40) in older than 34 PW) and social dystocia/uncontrolled pregnancy in older than 34 PW (4.47 (1.03-19.29)). CONCLUSIONS There are somatometric alterations and risk factors that can help in the early detection of neonates exposed to drugs of abuse. The somatometric alterations identified can be useful to extend the differential diagnosis of these alterations and to study their causes.
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Affiliation(s)
- Antonia Roca
- Unidad de Neonatología, Servicio de Pediatría, Hospital Universitario Son Espases, Palma de Mallorca, España
| | - Pilar Jarque
- Unidad de Neonatología, Servicio de Pediatría, Hospital Universitario Son Espases, Palma de Mallorca, España
| | - Isabel Gomila
- Servicio de Análisis Clínicos, Hospital Universitario Son Llàtzer, Palma de Mallorca, España; Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, España
| | - Emilia Marchei
- Centro Nacional de Adicciones y Dopaje, Instituto Superior de Salud, Roma, Italia
| | - Roberta Tittarelli
- Unidad de Toxicología Forense, Departamento de Ciencias Anatómicas, Histológicas, Forenses y Ortopédicas, Universidad de Sapienza, Roma, Italia
| | - Miguel Ángel Elorza
- Servicio de Análisis Clínicos, Unidad de Toxicología Clínica, Hospital Universitario Son Espases, Palma de Mallorca, España; Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, España
| | - Pilar Sanchís
- Departamento de Química, Universidad de las Islas Baleares, Palma de Mallorca, España; Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, España
| | - Bernardino Barceló
- Servicio de Análisis Clínicos, Unidad de Toxicología Clínica, Hospital Universitario Son Espases, Palma de Mallorca, España; Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, España.
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Malaca S, Marchei E, Barceló Martín B, Minutillo A, Pichini S. Novel fast ultra-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) and extraction of ethylglucuronide in meconium samples. Drug Test Anal 2019; 11:1471-1475. [PMID: 31177632 DOI: 10.1002/dta.2658] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/29/2019] [Accepted: 05/31/2019] [Indexed: 01/25/2023]
Affiliation(s)
- Sara Malaca
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Covilhã, Portugal.,Laboratório de Fármaco-Toxicologia -- UBIMedical, Universidade da Beira Interior, Covilhã, Portugal
| | - Emilia Marchei
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Bernardino Barceló Martín
- Clinical Toxicology Unit, Clinical Analysis Department, Hospital Universitari Son Espases, Research Institute of Health Sciences (IdISPa), Palma de Mallorca, Spain
| | - Adele Minutillo
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
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