nach oben

Erschienen in:

22.04.2021 | Original Article

Meconium and maternal hair analysis vs. medical records to monitor antidepressants and benzodiazepines exposure during pregnancy

verfasst von: Ángela López-Rabuñal, Elena Lendoiro, Marta Concheiro-Guisán, Eva González-Colmenero, Patricia Peñas-Silva, Ana Concheiro-Guisán, Manuel Macía-Cortiñas, Manuel López-Rivadulla, Ana de-Castro-Ríos, Angelines Cruz

Erschienen in: Forensic Toxicology | Ausgabe 2/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Psychiatric disorders and drugs used for their treatment, can have negative consequences for the pregnancy and the development of the newborn. Therefore, meconium, maternal hair and maternal medical records were compared for the detection of antidepressants and benzodiazepines exposure during pregnancy. Moreover, correlations between neonatal outcomes and meconium or maternal hair results were evaluated.

Methods

Two liquid chromatography-tandem mass spectrometric methods for the determination of the most common benzodiazepines and antidepressants in meconium and maternal hair were applied to the analysis of 145 matched samples. Statistical analyses were performed with IBM SPSS Statistics software.

Results

According to the medical records, 5.5% of the mothers used prescribed antidepressants during pregnancy and 23.1% benzodiazepines (10.5% at the time of delivery). For antidepressants, 5.5% of meconium and 24.8% of maternal hair specimens were positive; for benzodiazepines, 16.6 and 15.9% of meconium and hair specimens, respectively, were positive. Overall agreement meconium/hair, and medical records/hair, for positive cases, was very poor (28.1 and 18.9%, respectively), while improved between medical records/meconium (60%). Regarding the evaluated neonatal parameters, we only found a significant negative correlation between male weight and meconium-positive results for benzodiazepines.

Conclusion

Maternal hair was more sensitive to detect antidepressants use, while meconium analysis can provide detection of neonatal benzodiazepines exposure at the time of delivery. Therefore, combination of both matrices is recommended, since it shows a more complete picture of prenatal exposure to these drugs. No clear influence of prenatal exposure to antidepressants or benzodiazepines on neonatal outcomes was noticed.

Nur mit Berechtigung zugänglich

World Health Organization. Depression and other common mental disorders: global health estimates. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA3.0 IGO.

Le Strat Y, Dubertret C, Le Foll B (2011) Prevalence and correlates of major depressive episode in pregnant and postpartum women in the United States. J Affect Disord 135:128–138. https://doi.org/10.1016/j.jad.2011.07.004 CrossRefPubMed

Dennis C, Falah-Hassani K, Shiri R (2017) Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry 210:315–323. https://doi.org/10.1192/bjp.bp.116.187179 CrossRefPubMed

Hanley GE, Mintzes B (2014) Patterns of psychotropic medicine use in pregnancy in the United States from 2006 to 2011 among women with private insurance. BMC Pregnancy Childbirth 14:242. https://doi.org/10.1186/1471-2393-14-242 CrossRefPubMedPubMedCentral

Bais B, Molenaar NM, Bijma HH, Hoogendijk WJ, Mulder CL, Luik AI, Lambregtse-van den Berg AI, Kamperman AM (2020) Prevalence of benzodiazepines and benzodiazepine-related drugs exposure before, during and after pregnancy: a systematic review and meta-analysis. J Affect Disord 269:18–27. https://doi.org/10.1016/j.jad.2020.03.014 CrossRefPubMed

Pearlstein T (2015) Depression during pregnancy. Best Pract Res Clin Obstet Gynaecol 29:754–764. https://doi.org/10.1016/j.bpobgyn.2015.04.004 CrossRefPubMed

Cott AD, Wisner KL (2003) Psychiatric disorders during pregnancy. Int Rev Psychiatry 15:217–230. https://doi.org/10.1080/0954026031000136848 CrossRefPubMed

Iqbal MM, Sobhan T, Ryals T (2002) Effects of commonly used benzodiazepines on the fetus, the neonate, and the nursing infant. Psychiatr Serv 53:39–49. https://doi.org/10.1176/appi.ps.53.1.39 CrossRefPubMed

Oyebode F, Rastogi A, Berrisford G, Coccia F (2012) Psychotropics in pregnancy: safety and other considerations. Pharmacol Ther 135:71–77. https://doi.org/10.1016/j.pharmthera.2012.03.008 CrossRefPubMed

10.

Garg M, Garrison L, Leeman L, Hamidovic A, Borrego M, Rayburn WF, Bakhireva L (2016) Validity of self-reported drug use information among pregnant women. Matern Child Health J 20:41–47. https://doi.org/10.1007/s10995-015-1799-6 CrossRefPubMedPubMedCentral

11.

Lozano J, García-Algar O, Vall O, de la Torre R, Scaravelli G, Pichini S (2007) Biological matrices for the evaluation of in utero exposure to drugs of abuse. Ther Drug Monit 29:711–734. https://doi.org/10.1097/FTD.0b013e31815c14ce CrossRefPubMed

12.

Concheiro M, Huestis MA (2018) Drug exposure during pregnancy: analytical methods and toxicological findings. Bioanalysis 10:587–606. https://doi.org/10.4155/bio-2017-0260 CrossRefPubMed

13.

Friguls B, Joya X, Garcia-Serra J, Gómez-Culebras M, Pichini S, Martinez S, Vall O, Garcia-Algar O (2012) Assessment of exposure to drugs of abuse during pregnancy by hair analysis in a Mediterranean island. Addiction 107:1471–1479. https://doi.org/10.1111/j.1360-0443.2012.03828.x CrossRefPubMed

14.

Ostrea EM Jr, Knapp DK, Tannenbaum L, Ostrea AR, Romero A, Salari V, Ager J (2001) Estimates of illicit drug use during pregnancy by maternal interview, hair analysis, and meconium analysis. J Pediatr 138:344–348. https://doi.org/10.1067/mpd.2001.111429 CrossRefPubMed

15.

Concheiro M, González-Colmenero E, Lendoiro E, Concheiro-Guisán A, de Castro A, Cruz-Landeira A, López-Rivadulla M (2013) Alternative matrices for cocaine, heroin, and methadone in utero drug exposure detection. Ther Drug Monit 35:502–509. https://doi.org/10.1097/FTD.0b013e31828a6148 CrossRefPubMed

16.

Concheiro M, Lendoiro E, de Castro A, Gónzalez-Colmenero E, Concheiro-Guisan A, Peñas-Silva P, Macias-Cortiña M, Cruz-Landeira A, López-Rivadulla M (2017) Bioanalysis for cocaine, opiates, methadone, and amphetamines exposure detection during pregnancy. Drug Test Anal 9:898–904. https://doi.org/10.1002/dta.2087 CrossRefPubMed

17.

Joya X, Marchei E, Salat-Batlle J, García-Algar O, Calvaresi V, Pacifici R, Pichini S (2016) Drugs of abuse in maternal hair and paired neonatal meconium: an objective assessment of foetal exposure to gestational consumption. Drug Test Anal 8:864–868. https://doi.org/10.1002/dta.1921 CrossRefPubMed

18.

Joya X, Marchei E, Salat-Batlle J, García-Algar O, Calvaresi V, Pacifici R, Pichini S (2016) Fetal exposure to ethanol: relationship between ethyl glucuronide in maternal hair during pregnancy and ethyl glucuronide in neonatal meconium. Clin Chem Lab Med 54:427–435. https://doi.org/10.1515/cclm-2015-0516 CrossRefPubMed

19.

Cortes L, Almeida L, Sabra S, Muniesa M, Busardo FP, Garcia-Algar O et al (2018) Maternal hair and Neonatal Meconium to assess gestational cnsumption and prenatal exposure to drugs of abuse and psychoactive drugs. Curr Pharm Biotechnol 19:136–143. https://doi.org/10.2174/1389201019666180405163612 CrossRefPubMed

20.

López-Rabuñal A, Lendoiro E, Concheiro M, López-Rivadulla M, Cruz A, de-Castro-Ríos A (2020) LC-MS/MS method for the determination of antidepressants and benzodiazepines in meconium. J Anal Toxicol 44:580–588. https://doi.org/10.1093/jat/bkaa012 CrossRefPubMed

21.

Prego-Meleiro P, Lendoiro E, Concheiro M, Cruz A, López-Rivadulla M, de Castro A (2017) Development and validation of a liquid chromatography tandem mass spectrometry method for the determination of cannabinoids and phase I and II metabolites in meconium. J Chromatogr A 1497:118–126. https://doi.org/10.1016/j.chroma.2017.03.066 CrossRefPubMed

22.

Lendoiro E, Quintela O, de Castro A, Cruz A, López-Rivadulla M, Concheiro M (2012) Target screening and confirmation of 35 licit and illicit drugs and metabolites in hair by LC–MSMS. Forensic Sci Int 217:207–215. https://doi.org/10.1016/j.forsciint.2011.11.006 CrossRefPubMed

23.

Lendoiro E, González-Colmenero E, Concheiro-Guisán A, de Castro A, Cruz A, López-Rivadulla M, Concheiro M (2013) Maternal hair analysis for the detection of illicit drugs, medicines, and alcohol exposure during pregnancy. Ther Drug Monit 35:296–304. https://doi.org/10.1097/FTD.0b013e318288453f CrossRefPubMed

24.

Wikner BN, Stiller C, Bergman U, Asker C, Källén B (2007) Use of benzodiazepines and benzodiazepine receptor agonists during pregnancy: neonatal outcome and congenital malformations. Pharmacoepidemiol Drug Saf 16:1203–1210. https://doi.org/10.1002/pds.1457 CrossRefPubMed

25.

Calderon-Margalit R, Qiu C, Ornoy A, Siscovick DS, Williams MA (2009) Risk of preterm delivery and other adverse perinatal outcomes in relation to maternal use of psychotropic medications during pregnancy. Am J Obstet Gynecol 201:579. e1-579. e8. https://doi.org/10.1016/j.ajog.2009.06.061 CrossRef

26.

Hendrick V, Smith LM, Suri R, Hwang S, Haynes D, Altshuler L (2003) Birth outcomes after prenatal exposure to antidepressant medication. Am J Obstet Gynecol 188:812–815. https://doi.org/10.1067/mob.2003.172 CrossRefPubMed

27.

Sahingöz M, Yuksel G, Karsidag C, Uguz F, Sonmez EO, Annagur BB, Annagur A (2014) Birth weight and preterm birth in babies of pregnant women with major depression in relation to treatment with antidepressants. J Clin Psychopharmacol 34:226–229. https://doi.org/10.1097/JCP.0000000000000077 CrossRefPubMed

28.

Ogawa Y, Takeshima N, Furukawa TA (2018) Maternal exposure to benzodiazepine and risk of preterm birth and low birth weight: a case-control study using a claims database in Japan. Asia Pac Psychiatry 10:e12309. https://doi.org/10.1111/appy.12309 CrossRefPubMed

29.

Freeman MP, Góez-Mogollón L, McInerney KA, Davies AC, Church TR, Sosinsky AZ, Noe OB, Ciguera AC, Cohen LS (2018) Obstetrical and neonatal outcomes after benzodiazepine exposure during pregnancy: results from a prospective registry of women with psychiatric disorders. Gen Hosp Psychiatry 53:73–79. https://doi.org/10.1016/j.genhosppsych.2018.05.010 CrossRefPubMed

Titel: Meconium and maternal hair analysis vs. medical records to monitor antidepressants and benzodiazepines exposure during pregnancy
verfasst von: Ángela López-Rabuñal
Elena Lendoiro
Marta Concheiro-Guisán
Eva González-Colmenero
Patricia Peñas-Silva
Ana Concheiro-Guisán
Manuel Macía-Cortiñas
Manuel López-Rivadulla
Ana de-Castro-Ríos
Angelines Cruz
Publikationsdatum: 22.04.2021
Verlag: Springer Singapore
Erschienen in: Forensic Toxicology / Ausgabe 2/2021
Print ISSN: 1860-8965
Elektronische ISSN: 1860-8973
DOI: https://doi.org/10.1007/s11419-021-00576-9

Neu im Fachgebiet Rechtsmedizin

30.10.2023 | Morphin | CME

Springer Medizin

Meconium and maternal hair analysis vs. medical records to monitor antidepressants and benzodiazepines exposure during pregnancy

Abstract

Purpose

Methods

Results

Conclusion

Neu im Fachgebiet Rechtsmedizin

Nachweis eines Heroinkonsums

Knochentumoren des Kindes- und Jugendalters

Rezeptor-Tyrosinkinase-Fusionen in spindelzelligen Tumoren des Kindesalters

Periphere neuroblastische Tumoren im Kindesalter

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2021

A comparison between two different dried blood substrates in determination of psychoactive substances in postmortem samples

Fatal intoxication with U-47700 in combination with other NPS (N-ethylhexedrone, adinazolam, 4-CIC, 4-CMC) confirmed by identification and quantification in autopsy specimens and evidences

A potential of methoxpropamine to be a widespread recreational drug: it blocks NMDA receptors and inhibits NMDA receptor-mediated synaptic transmission in a brain preparation of mice

A fluorine turns a medicinal benzodiazepine into NPS: the case of flualprazolam

Increased production of illegal alcoholic beverages during the COVID-19 pandemic in Hamadan, Iran

Recent progress in the chemical attribution of chemical warfare agents and highly toxic organophosphorus pesticides

Neu im Fachgebiet Rechtsmedizin

Nachweis eines Heroinkonsums

Knochentumoren des Kindes- und Jugendalters

Rezeptor-Tyrosinkinase-Fusionen in spindelzelligen Tumoren des Kindesalters

Periphere neuroblastische Tumoren im Kindesalter