Neonatal Cord Tox Panel and Maternal Perinatal Fentanyl Exposure: A Retrospective Chart Review  

作　　者：Joseph Jones Donna Coy Ryan Mitacek Stephanie Thompson Stefan Maxwell Joseph Jones;Donna Coy;Ryan Mitacek;Stephanie Thompson;Stefan Maxwell(United States Drug Testing Laboratories, Des Plaines, Illinois, USA;Charleston Area Medical Center, Charleston, West Virginia, USA;Pediatrix Medical Group, Sunrise, Florida, USA)

机构地区：[1]United States Drug Testing Laboratories, Des Plaines, Illinois, USA [2]Charleston Area Medical Center, Charleston, West Virginia, USA [3]Pediatrix Medical Group, Sunrise, Florida, USA

出　　处：《American Journal of Analytical Chemistry》2021年第9期324-331,共8页美国分析化学（英文）

摘　　要：<strong>Objective:</strong> The specific aim of this study was to determine if the currently available cutoff for fentanyl in umbilical cord (UC) was appropriate to distinguish illicit fentanyl exposure from therapeutic in-hospital administration of fentanyl. <strong>Study Design</strong><strong>:</strong> Medical record review was conducted for perinatal administration of fentanyl and the detection of fentanyl in the corresponding routine UC toxicology. Specimens were initially tested with immunoassay followed by mass spectrometry (n = 62). <strong>Result:</strong> Excluding a single specimen that was confirmed positive, specimens were below the assays’ limit of quantification. The immunoassay’s mean b/b₀ for the cases that received and did not receive fentanyl prior to delivery was 91.3% ± 10.6% and 98.2% ± 6.5%, respectively (p = 0.003). <strong>Conclusion:</strong> We demonstrated that UC is a suitable specimen type for the detection of fentanyl and that the cutoff selected adequately identifies illicit fentanyl use while not flagging cases where fentanyl was administered by the hospital prior to birth.<strong>Objective:</strong> The specific aim of this study was to determine if the currently available cutoff for fentanyl in umbilical cord (UC) was appropriate to distinguish illicit fentanyl exposure from therapeutic in-hospital administration of fentanyl. <strong>Study Design</strong><strong>:</strong> Medical record review was conducted for perinatal administration of fentanyl and the detection of fentanyl in the corresponding routine UC toxicology. Specimens were initially tested with immunoassay followed by mass spectrometry (n = 62). <strong>Result:</strong> Excluding a single specimen that was confirmed positive, specimens were below the assays’ limit of quantification. The immunoassay’s mean b/b₀ for the cases that received and did not receive fentanyl prior to delivery was 91.3% ± 10.6% and 98.2% ± 6.5%, respectively (p = 0.003). <strong>Conclusion:</strong> We demonstrated that UC is a suitable specimen type for the detection of fentanyl and that the cutoff selected adequately identifies illicit fentanyl use while not flagging cases where fentanyl was administered by the hospital prior to birth.

关 键 词：FENTANYL Norfentanyl Umbilical Cord Prenatal Fentanyl Exposure 

分 类 号：R61[医药卫生—外科学]