Illicit drug use by pregnant women in metropolitan, medium sized, and rural counties using meconium sampling
OBJECTIVE: The purpose of this study was to compare illicit drug use by pregnant women in metropolitan, medium sized, and rural counties using neonatal meconiurn sampling. METHODS: Twelve counties in Indiana were selected to participate in a statewide anonymous drug screening protocol. The counties were classified based on population. Metropolitan counties had a population 150,000 residents. Medium sized counties had between 50,000 and 150,000 residents. Rural counties had populations <50,000. Following the deliver)' of an infant, a two gram sample of the first meconium was collected. The meconiurn sample was analyzed using florescence polarization immunoassay. All positive samples were confirmed by gas chromatography and mass spectroscopy. Substances detected by meconium analysis included amphetamines, cocaine, cannabinoids, opiates, and PCP. Statistical analysis was performed using Chi-square for categorical data. Statistical significance was set al a p value of s.05. RESULTS: 32 hospitals participated in the study. 964 samples were collected: 347 from metropolitan counties, 169 from medium sized counties, and 448 from rural counties. The prevalences of positive meconium screens from metropolitan, medium si/ed, and rural counties were 7.2%, 5.3%, and 4.2%, respectively. This difference was not significant. The most common drug detected in all samples wasTHC, 36 positive samples (3.7% ). The prevalences of THC were similar for metropolitan, medium sized, and rural counties, 4.6%, 4.7%, and 2.7% respectively. Cocaine was detected in 11 of 964 samples (1.1%). Cocaine metabolites were more common in metropolitan counties when compared to medium sized and rural counties, 2.3%, 0%, and 0.6%, respectively. CONCLUSION: Meconium testing confirms that illicit drug use in pregnancy is a significant problem in rural counties as well as urban centers.
